Oncology & Hematology Coding Alert

Hepatocellular carcinomas and hepatoblastomas split paths under ICD-10.

When you start using ICD-10 in 2013, you'll have to leave your 155.0 comfort zone and start using more specific codes for primary liver neoplasms.

ICD-9: A number of diagnoses fall under the ICD-9 code you currently use:

• 155.0, Malignant neoplasm of liver primary

Carcinoma:

liver, specified as primary

hepatocellular

liver cell

Hepatoblastoma

ICD-10: The new code set does not provide a one-to-one corresponding code. Instead, you'll need to choose from a number of possibilities:

• C22.0, Liver cell carcinoma

Hepatocellular carcinoma

Hepatoma

• C22.2, Hepatoblastoma
• C22.3, Angiosarcoma of liver

Kupffer cell sarcoma

• C22.4, Other sarcomas of liver
• C22.7, Other specified carcinomas of liver
• C22.8, Malignant neoplasm of liver, primary, unspecified as to type.

Documentation: If your practice's current documentation format doesn't allow quick access to whether the patient's diagnosis is hepatoma rather than hepatoblastoma or angiosarcoma, add the C22.- diagnoses to your provider education and clinical documentation improvement strategy in preparation for the transition to ICD-10.

Coder tip: For the C22.- codes, ICD-10 instructs you to use an additional code to identify:

• Alcohol abuse and dependence (F10.-)
• Hepatitis B (B16.-, B18.0-B18.1)
• Hepatitis C (B17.1-, B18.2).

Remember: When ICD-10 goes into effect on Oct. 1, 2013, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.