C22.0
BillableLiver cell carcinoma
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C22.0 an HCC code?
Yes. C22.0 maps to Lung and Other Severe Cancers under the CMS-HCC V28 risk adjustment model (and Lung and Other Severe Cancers under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for C22.0
For C22.0 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed C22.0 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C22.0 is the ICD-10-CM diagnosis code for liver cell carcinoma. Hepatocellular carcinoma, the most common type of primary liver cancer that develops from the main liver cells. It typically occurs in people with chronic liver disease or cirrhosis. C22.0 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of digestive organs (c15-c26).
Under the CMS-HCC V28 risk adjustment model, C22.0 maps to Lung and Other Severe Cancers (HCC 20) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, C22.0 mapped to the same category but with a base RAF weight of 0.973 — V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Document whether this is associated with hepatitis B, hepatitis C, cirrhosis, or other risk factors. Because C22.0 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for C22.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document whether this is associated with hepatitis B, hepatitis C, cirrhosis, or other risk factors
- •Distinguish from intrahepatic bile duct carcinoma (C22.1) and other liver malignancies
Clinical Significance
Hepatocellular carcinoma is the most common type of primary liver cancer and the sixth most common cancer worldwide. It predominantly occurs in patients with underlying chronic liver disease, including hepatitis B, hepatitis C, alcoholic liver disease, and nonalcoholic steatohepatitis-related cirrhosis. This diagnosis carries a high risk adjustment weight because patients require complex, multidisciplinary care including potential liver transplantation, locoregional therapies, and systemic immunotherapy.
Documentation Requirements
- ✓Pathological or clinical confirmation of hepatocellular carcinoma (not just liver mass)
- ✓Underlying liver disease etiology (hepatitis B, hepatitis C, alcoholic cirrhosis, nonalcoholic steatohepatitis)
- ✓Stage of disease (Barcelona Clinic Liver Cancer staging, TNM, or both)
- ✓Liver function assessment (Child-Pugh score, Model for End-Stage Liver Disease score)
- ✓Treatment approach (resection, transplant, ablation, transarterial chemoembolization, systemic therapy)