Malignant neoplasm of liver and intrahepatic bile ducts
Chapter 2:Neoplasms
ICD-10 C22 is a billable code used to indicate a diagnosis of malignant neoplasm of liver and intrahepatic bile ducts.
Malignant neoplasm of the liver and intrahepatic bile ducts encompasses a variety of liver cancers, including hepatocellular carcinoma (HCC) and cholangiocarcinoma. These malignancies often arise in the context of chronic liver disease, particularly cirrhosis, which can be caused by hepatitis B or C infections, alcohol abuse, or non-alcoholic fatty liver disease. The presence of cirrhosis significantly increases the risk of developing liver cancer, as the regenerative nodules can undergo malignant transformation. Alpha-fetoprotein (AFP) levels are commonly monitored in patients at risk for HCC, as elevated levels can indicate the presence of liver cancer, although not all cases will present with elevated AFP. Liver transplantation is a potential curative treatment for eligible patients with early-stage liver cancer, but strict criteria must be met, including tumor size and number, as well as the absence of extrahepatic disease. The management of liver cancer requires a multidisciplinary approach, including oncologists, hepatologists, and transplant surgeons, to optimize patient outcomes.
Detailed history of liver disease, imaging results, and laboratory findings including AFP levels.
Patients presenting with elevated liver enzymes, jaundice, or abdominal pain; routine surveillance in cirrhotic patients.
Ensure documentation reflects the relationship between cirrhosis and the development of liver cancer.
Pathology reports confirming malignancy, staging information, and treatment plans.
Patients undergoing chemotherapy, targeted therapy, or preparing for liver transplantation.
Accurate staging and documentation of treatment response are critical for coding.
Used for patients with early-stage liver cancer meeting transplant criteria.
Document eligibility criteria, tumor size, and number.
Involves coordination between hepatology and transplant surgery.
Elevated AFP levels can indicate the presence of hepatocellular carcinoma, especially in patients with cirrhosis or chronic liver disease. However, not all patients with HCC will have elevated AFP, so it should be used in conjunction with imaging and clinical findings.
