Brain Molecular Markers (CNS Other)

Note 1 This data item applies only to ICD-O-3 histology codes 9400/3, 9401/3, 9440/3, 9450/3, 9451/3, 9471/3 and 9478/3. If a microscopically confirmed histology is not included in this list, assign, code 85.

• If your case is not microscopically confirmed, code 99

Note 2 Physician statement of histologic subtype can be used to code this data item.

Note 3 Only one code is applicable for each tumor.

• IDH mutation status distinguishes between clinically important subtypes within ICD-O-3 9400/3, Diffuse astrocytoma and 9401/3, Anaplastic astrocytoma.
• IDH mutant and 1p/19q co-deletion distinguishes between clinically important subtypes within ICD-O-3 code 9450/3, Oligodendroglioma and 9451/3, Anaplastic Oligodendroglioma.
• IDH-wildtype distinguishes clinically important subtypes within ICD-O-3 9400/3, Diffuse astrocytoma, 9401/3, Anaplastic astrocytoma and 9440/3, Glioblastoma, Epithelioid glioblastoma and Glioblastoma, NOS (note that the new ICD-O-3 code 9445/3 applies to Glioblastoma, IDH-mutant; information regarding this subtype is not collected using this data item).
• SHH-activation and TP53-wildtype distinguishes between clinically important subtypes within ICD-O-3 histology code 9471/3, Medulloblastoma.
• C19MC alteration status distinguishes a clinically important highly aggressive subtype within ICD-O-3 9478/3, Embryonal tumor with multilayered rosettes.

*Examples*
1. Biopsy of brain tumor, microscopic confirmation diagnosis Diffuse Astrocytoma (9400/3). Additional testing done, and IDH-mutant is identified. Code 01.
2. Biopsy of brain tumor, microscopic confirmation diagnosis Anaplastic astrocytoma (9401/3). No further testing or results unknown. Code 99.
3. MRI of brain tumor, clinical diagnosis glioblastoma. No further workup. Code 99.
4. Biopsy of brain tumor, microscopic confirmation diagnosis Mixed glioma (9382/3). Code 85.