TN 13 (09-15)

DI 23022.246 Oligodendroglioma Brain Cancer - Grade III

COMPASSIONATE ALLOWANCE INFORMATION

OLIGODENDROGLIOMA BRAIN CANCER- GRADE III

ALTERNATE NAMES

Anaplastic Oligodendroglioma

DESCRIPTION

Oliogodendroglioma (OD) Brain Cancer is a rare, slow growing cancer that initially consists of oligodendrocytes, which are, cells that cover and protect nerve cells in the brain and spinal cord. Cancers that are located in the frontal lobe may cause weakness on one side of the body, personality or behavior changes, and difficulty with short- term memory. Cancers occurring in the temporal lobe of the brain may cause seizures or language problems. These cancers rarely metastasize outside of the nervous system. The exact cause of OD brain cancer is unknown.

DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM CODING

Diagnostic testing: Oligodendrogliomas are diagnosed using CT or MRI scans. Brain biopsy is definitive.

Physical findings: People with these cancers may present with complaints of headaches, seizures, increased intracranial pressure, and neurological deficits such as, visual loss, motor weakness, and cognitive decline.

ICD-9: 191.X Depends on the location of the tumor.

ONSET AND PROGRESSION

Oligodendrogliomas can occur at any age, but are commonly diagnosed in young and middle age adults with a median age between 40 -50 years of age. This cancer may occasionally be found in children. Because low-grade cancers are slow growing, they are often present for years before they are diagnosed; however, higher grade cancers are likely to grow more quickly.

TREATMENT

The treatment of OD cancers depends on the size, location, and grade of cancer. Biopsy is generally performed to confirm the diagnosis and to grade the cancer. Recurrent low grade oliogodendrogliomas may be treated with a combination of surgical resection, chemotherapy and radiation.

SUGGESTED PROGRAMMATIC ASSESSMENT*

Suggested MER for evaluation:

  • Clinical history and examination that describes the diagnostic features of the impairment.

  • Biopsy report.

  • Imaging study results.

Suggested Listings for Evaluation:

DETERMINATION

LISTING

REMARKS

Meets Listing

13.13A1

113.13

Meets listings 13.13A1 and 113.13 upon confirmed diagnosis, regardless of effectiveness of treatment.

Equals Listing

  

* Adjudicators may, at their discretion, use the Medical Evidence of Record or Listings suggested to evaluate the claim. However, the decision to allow or deny the claim rests with the adjudicator.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0423022246
DI 23022.246 - Oligodendroglioma Brain Cancer - Grade III - 09/25/2015
Batch run: 09/25/2015
Rev:09/25/2015