Program Operations Manual System (POMS)
TN 61 (10-23)
DI 23022.185 Glioblastoma Multiforme (Adult Brain Cancer)
COMPASSIONATE ALLOWANCES INFORMATION
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GLIOBLASTOMA
MULTIFORME
(ADULT BRAIN CANCER)
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ALTERNATE NAMES
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Glioblastoma; Glioblastoma Adult Brain Tumor; GBM; Grade IV astrocytoma; Diffuse Midline
Glioma; H3K27M-Mutant; Giant Cell Glioblastoma; Gliosarcoma; Gliosarcoma, IDH Wildtype;
Glioblastoma, IDH Wildtype; Glioblastoma, IDH Mutant; Glioblastoma, NOS
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DESCRIPTION
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Glioblastoma
Multiforme is a fast-growing type of central nervous system cancer that forms from glial (supportive)
tissue of the brain and spinal cord and has cells that look very different from normal
cells. It spreads aggressively throughout the brain tissue and is the most malignant
of the primary brain cancers. In consequence, these cancers are difficult to treat
and often recur after initial therapy. Glioblastoma multiforme most often occurs in
adults between the ages of 45 and 70 years and affects the brain more often than the
spinal cord.
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DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND
ICD-9–CM/ICD-10-CM
CODING
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Diagnostic testing: Diagnosis is based on:
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Neurological examination; and
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The only definitive test that can provide a diagnosis of glioblastoma is a biopsy
of the cancer. Testing to confirm diagnosis of glioblastoma includes neuroimaging
(CT and MRI) to provide information about the location, size and shape of the cancer.
Physical findings: Individuals with this impairment may present with:
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Slowly progressive neurologic deficits;
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Motor weakness; Increased intracranial pressure including headaches, nausea, and vomiting,
and cognitive impairments;
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Changes in mood and personality; and
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ICD-9: 191.9
ICD-10: C71.9
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PROGRESSION
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Glioblastoma multiforme is highly aggressive, infiltrating, and responds poorly to
all currently available treatments. The prognosis is grim, as most patients die within
2 years and few survive longer than three years.
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TREATMENT
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Treatment of glioblastoma multiforme may include the following: surgery, radiation
and/or chemotherapy.
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SUGGESTED PROGRAMMATIC
ASSESSMENT* |
Suggested Listings for
Evaluation:
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Pathology report of the cancer biopsy or surgical specimen is the critical information
necessary for disability evaluation;
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Clinical history and examination that describes the diagnostic features of the impairment;
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Results of neuroimaging (e.g. CT scan, MRI scan).
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Suggested Listings for
Evaluation: |
DETERMINATION |
LISTING
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REMARKS |
Meets |
13.13 A 1 |
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113.13 A
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Equals |
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* Adjudicators may, at their discretion, use the Medical Evidence of Record or the
listings suggested to evaluate the claim. However, the decision to allow or deny the
claim rests with the adjudicator.
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