| Cytology results | Morphology*/Behavior ** | Grade |
|---|---|---|
|
High grade urothelial carcinoma or “suspicious for high-grade urothelial carcinoma” (SHGUC of the Paris classification). (See ANNEX 2, section “Paris System reporting for urine cytology”, paragraph “Behavior of high grade tumors diagnosed by cytology only”). |
8130/2 (papillary appearance) or 8120/2 | 3 |
(*) If you only have cytological examination, try to find out if the tumor has a papillary appearance (8130) or not (8120) by reviewing the imaging.
(**) If the clinical impression (e.g. scans) is of invasive disease, then code with/3 behavior code.
Non-urothelial malignant cells seen on cytology should be coded according to the pathology report and clinical information.
If the topography of the tumor is highlighted on radiology/imaging, code the specific site. Otherwise, code the topography C68.9 (urinary tract, NOS).”