Question: 20170057

Status


Final

Category


#1:   Grade
#2:  
#3:  


References


Source 1:   2014+ Grade Instructions
pgs:  
Notes:   Solid Tumors
Source 2:   2016 SEER Manual
pgs:  
Notes:   data item: Grade, Differentiation, or Cell Indicator


Question


Grade:  If the biopsy site is a higher grade, is the grade of the biopsy used over the grade of the surgical resection?  See Discussion.



Discussion


When coding tumor grade, our pathologists have told us to code grade based on the specimen from the most definitive surgery or with the most amount of tissue, and that coding grade from the biopsy would not be appropriate even if it is a higher grade than from the surgical resection. Coding of solid tumors Instruction 5 states: If there is more than one grade, code the highest grade within the applicable system. Code the highest grade even if it is only a focus. Code grade in the following priority order using the first applicable system.  



Answer


For cases diagnosed prior to 2018: Use the Grade Coding Instructions to code grade. The instructions are intended to standardize coding of grade across the U.S. and to eliminate differences in opinion between pathologists. Standardized coding ensures that data can be combined and used for statistical analysis.
You may code grade based on the biopsy when following the grade coding instructions.



History




Last Updated


09/05/2017

Date Finalized


11/08/2017