C18.3
BillableMalignant neoplasm of hepatic flexure
HCC Category Mapping
V28HCC 22 — Colorectal, Bladder, and Other Cancers
0.000V24HCC 11 — Colorectal, Bladder, and Other Cancers
0.306ESRDHCC 11 — Colorectal, Bladder, and Other Cancers
0.000What This Code Means
Cancer that develops at the hepatic flexure, which is the bend in the colon where the ascending colon turns to become the transverse colon, located near the liver.
Coding Tips
- •Hepatic flexure tumors are anatomically challenging for surgical resection; document surgical approach if available
- •This location is sometimes classified with right-sided colon cancers for treatment purposes
Clinical Significance
Malignant neoplasm of the hepatic flexure occurs at the bend where the ascending colon turns to become the transverse colon, located near the liver. This location presents unique surgical challenges due to proximity to the hepatic vessels, duodenum, and right kidney. Hepatic flexure cancers are classified with right-sided cancers but require distinct surgical approaches, often needing extended right hemicolectomy.
Documentation Requirements
- ✓Documentation specifying hepatic flexure as the tumor location
- ✓Histological type confirmed by pathology
- ✓Stage of disease
- ✓Relationship to adjacent structures (liver, duodenum, kidney)
- ✓Surgical approach and extent of resection
Commonly Confused Codes
C18.2 — Ascending colon: the ascending colon is below the hepatic flexure; confirm documentation specifies the flexure, not just the ascending segmentC18.4 — Transverse colon: the transverse colon begins after the hepatic flexure; ensure the tumor is at the turn, not in the straight transverse portionC78.7 — Secondary malignant neoplasm of liver: do not confuse liver metastasis with hepatic flexure primary cancer
Code Hierarchy
└C18Malignant neoplasm of colon└C18.3Malignant neoplasm of hepatic flexure
└C18.3Malignant neoplasm of hepatic flexure