The February 2024 Registry Partners Oncology Coding Break presents the topic of grade coding updates. The grade manual coding instructions are reviewed beginning with autopsy grading that has been added to the manual. The findings from the autopsy direct the ODS-C to the correct grade time frame (clinical, post-therapy clinical, pathological, and post therapy pathological) and we cannot assume autopsy grade should be assigned to pathological grade per the instructions.
The grade manual added instructions for endometrioid schema, which included assigning code 2 if low grade is documented and assigning code 3 when high grade is documented. Version 9 for brain, CNS Other, and Intracranial Gland schema has updated instructions for code 2 WHO Grade II, code 3 WHO Grade III, and code 4 WHO Grade IV. Also, there have been clarifications for grade post therapy path (yp) and grade pathological. Note 6 for each data item has been updated under code 9 for unknown. Lastly, the general grade coding instructions for solid tumor rules has a new #4 general guideline for priority. A priority for grade has been added to include synoptic reporting as first priority, then pathology report final diagnosis before taking a physician statement. There are case examples throughout the presentation to assist with in-sight to grade coding updates.