Program Operations Manual System (POMS)
TN 32 (08-20)
COMPASSIONATE
ALLOWANCE INFORMATION |
MEDULLOBLASTOMA
|
ALTERNATE NAMES
|
|
DESCRIPTION
|
Medulloblastoma is a rare type of malignant brain cancer that occurs in the cerebellum and adjacent
tissue (which control body movement and coordination). Medulloblastomas are primarily
a type of childhood brain cancer, and rarely occur in adults.
|
DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND
ICD-9-CM/ICD-10-CM
CODING
|
Diagnostic testing: The diagnosis of a medulloblastoma is made by:
-
•
Imaging tests including MRI of the brain and spine; CT, PET scan, and radionuclide
bone scans;
-
•
A spinal tap may be performed to obtain cerebral spinal fluid to search for cancer
cells or tumor markers; and
-
•
Analysis of the tumor after surgical resection confirms the diagnosis of medulloblastoma.
Physical findings: Individuals with a medulloblastoma may present with:
-
•
Headaches which are often worse in the morning and get better during the day;
-
•
Nausea or vomiting in the morning;
-
•
Problems with motor skills, such as clumsiness or poor handwriting;
-
-
•
Tilting the head to one side;
-
•
Double vision (diplopia);
-
•
Rapid, jerky eye movements (nystagmus);
-
-
•
Ringing in the ears (tinnitus);
-
-
-
-
•
Inability to control bladder and bowel functions.
ICD-9: 191.6
ICD-10: C71.6
|
PROGRESSION
|
Prognosis is poor for medulloblastoma.
|
TREATMENT
|
Surgery alone does not cure this type of cancer. Chemotherapy and radiation are often
used in combination with surgery.
|
SUGGESTED PROGRAMMATIC ASSESSMENT*
|
Suggested MER for Evaluation:
-
•
Clinical history and examination that describes the diagnostic features of the impairment;
-
•
Pathology/biopsy report of the cancer;
-
•
If a pathology report is unavailable, a surgical report or all radiological studies
(for example, MRI and CT scans) and treatment notes indicating antineoplastic therapy
for metastases may be substituted; and
-
•
If available, spinal tap results.
|
Suggested Listings for Evaluation:
|
DETERMINATION
|
LISTING
|
REMARKS
|
Meets
|
13.13 A 2
|
Medulloblastoma meets the criteria in listing 13.13 A 2 upon confirmed diagnosis,
regardless of the effectiveness of treatment.
|
113.13 B
|
Medulloblastoma meets the criteria in listing 113.13 B upon confirmed diagnosis, regardless
of the effectiveness of treatment.
|
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.
|