C22.0 ICD-10-CM Code: Liver cell carcinoma
C22.0 maps to CMS-HCC V28 20. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of digestive organs (C15-C26)
C22.0
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceLiver 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.
Buddy Insight
Hepatocellular carcinoma is the most common type of primary liver cancer and the sixth most common cancer worldwide.
CMS-HCC V28
MappedHCC 20
Coefficient HCC 20: 1.136 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 009
Code-level coefficient reference
ESRD/PACE
MappedHCC 9
Code-level coefficient reference
RXHCC
MappedHCC 20
Code-level coefficient reference
Code Book Path
Inclusion Terms
Official- Hepatocellular carcinoma
- Hepatoma
Excludes 2
Official- gastrointestinal stromal tumors (C49.A-)Inherited from C15-C26
Related Codes
Includes
OfficialNo Includes notes are included in this display for C22.0. Check the code and parent instructions in the Code Book.
Excludes 1
Official- Kaposi's sarcoma of gastrointestinal sites (C46.4)Inherited from C15-C26, C22
- malignant neoplasm of biliary tract NOS (C24.9)Inherited from C15-C26, C22
- secondary malignant neoplasm of liver and intrahepatic bile duct (C78.7)Inherited from C15-C26, C22
Code First
OfficialNo Code First sequencing instructions are included in this display for C22.0. Check the code and parent instructions in the Code Book.
Use Additional
Official- code to identify:Inherited from C22
- alcohol abuse and dependence (F10.-)Inherited from C22
- hepatitis B (B16.-, B18.0-B18.1)Inherited from C22
- hepatitis C (B17.1-, B18.2)Inherited from C22
Code Also
OfficialNo Code Also instructions are included in this display for C22.0. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is C22.0 an HCC code?
Yes. C22.0 (Liver cell carcinoma) maps to HCC 20, Lung and Other Severe Cancers under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 1.136. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: C22.0 is billable and maps to V28 HCC 20, Lung and Other Severe Cancers. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- C22.0
- Description
- Liver cell carcinoma
- HCC (V28)
- HCC 20 — Lung and Other Severe Cancers
- RAF reference coefficient
- 1.136
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work C22.0 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for C22.0
For C22.0, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
Coder workflow notes
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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 source-labeled community, non-dual, aged reference coefficient of 1.136. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
Liver cell carcinoma (hepatocellular carcinoma, HCC), primary liver cancer, the most common liver malignancy. Often develops on a background of cirrhosis. For C22.0, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, 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
- •Liver cell carcinoma (hepatocellular carcinoma, HCC), primary liver cancer, the most common liver malignancy. Often develops on a background of cirrhosis.
- •Do not confuse the tumor HCC (liver cell carcinoma) with the CMS-HCC category HCC. These are unrelated usages of the same three-letter acronym.
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)
Commonly Confused Codes
- •C22.1: Intrahepatic bile duct carcinoma (cholangiocarcinoma): different cell origin; hepatocellular carcinoma arises from hepatocytes, cholangiocarcinoma from bile duct cells
- •C78.7: Secondary malignant neoplasm of liver: metastatic cancer TO the liver from another primary site; critical distinction
- •C22.8: Primary liver cancer, unspecified type: use C22.0 when hepatocellular carcinoma is confirmed
- •C22.9: Liver cancer, not specified as primary or secondary: use C22.0 when primary hepatocellular carcinoma is confirmed