| 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.
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               | DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM/ICD-10-CM CODING | Diagnostic testing: OD cancers are diagnosed using computed tomography (CT) or magnetic resonance imaging
                     (MRI) scans. A brain biopsy is definitive when determined to be a diffuse infiltrating
                     glioma with isocitrate dehydrogenase (IDH) mutation and chromosomal 1p19q codeletion.
                   Physical findings: People with these cancers may present with complaints of:
                   
                     
                        
                     
                        
                     
                        
                           • 
                              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
                   ICD-10: C71.9
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               | PROGRESSION | OD cancers 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.
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               | 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 OD cancers may be treated with a combination of surgical resection, chemotherapy
                     and radiation.
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               | SUGGESTED PROGRAMMATIC ASSESSMENT* | 
            
               
               | Suggested MER for Evaluation: 
                     
                        
                           • 
                              Clinical history and examination that describes the diagnostic features of the impairment;
                        
                     
                        
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               | Suggested Listings for Evaluation: | 
            
               
               | DETERMINATION  | LISTING | REMARKS  | 
            
               
               | Meets | 13.13 A 1 | Meets the criteria in listing 13.13 A 1 upon confirmed diagnosis, regardless of effectiveness
                     of treatment.
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               | 113.13 | Meets the criteria in listing 113.13 upon confirmed diagnosis, regardless of effectiveness
                     of treatment.
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               | Equals |   |   | 
            
               
               | * 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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