Tumor Tip of the Week-Kidney Grade - Omega Healthcare

Tumor Tip of the Week-Kidney Grade

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  1. Scenario: 2022
  • Kidney biopsy: Renal Cell CA, Clear Cell Renal Cell CA, Nuclear Grade 2.

Question:  How would you code the clinical grade?

  • 2 Stated as WHO/ISUP Grade 2
  • B Moderately differentiated
  • 9 Grade cannot be assessed (GX); Unknown

Answer: B

Grade Manual

Preferred grading system for Kidney is WHO/ISUP, not nuclear grade. 

  • Refer to Coding Guidelines for Generic Grade Categories page 33-34
    • Use the table when the appropriate grade table for a cancer uses the generic categories with alphabetic codes A-D, OR for a cancer site which includes codes A-D for when the priority grade system was not used/documented. In addition, do not use the table for a cancer that uses the generic categories but assigns numeric codes. The latter condition means that the site uses nuclear grading for which the alphabetic codes are not appropriate. Per the Table, Nuclear Grade 2 is assigned a code of B

CAnswer Forum Post
https://cancerbulletin.facs.org/forums/forum/site-specific-data-items-grade-2018/95766-grade-kidney#post97568

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  • Scenario: 2022
  • Kidney biopsy: Renal Cell CA, Clear Cell Renal Cell CA, WHO/ISUP grade (Furhman nuclear grade): 1

Question:  How would you code the clinical grade?

  • 1
  • A
  • 9

Answer: 1

Grade Manual You can code it to 1 since they are documenting the WHO/ISUP grade as 1 and have the Fuhrman grade in parenthesis.

CAnswer Forum Post
https://cancerbulletin.facs.org/forums/forum/site-specific-data-items-grade-2018/95766-grade-kidney#post97568

  • Scenario: 2022
  • Kidney biopsy: Renal Cell CA, Clear Cell Renal Cell CA, Fuhrman Grade 2.

Question:  How would you code the clinical grade?

  • 2 Stated as WHO/ISUP Grade 2
  • B Moderately differentiated
  • 9 Grade cannot be assessed (GX); Unknown/ Only Fuhrman grade documented

Answer: 9

Grade Manual

Preferred grading system for Kidney is WHO/ISUP, not Fuhrman grade.  Code 9 when Only Fuhrman grade documented

CAnswer Forum Post
https://cancerbulletin.facs.org/forums/forum/site-specific-data-items-grade-2018/95766-grade-kidney#post97568

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