What is ICD-10 code C22.2?

C22.2 is the ICD-10-CM diagnosis code for Hepatoblastoma. A type of liver cancer that primarily affects infants and young children, arising from immature liver cells. It is the most common liver cancer in children. It belongs to the ICD-10-CM chapter for neoplasms (c00-d49). C22.2 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. C22.2 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. C22.2 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. C22.2 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does C22.2 map to under V28?

C22.2 maps to CMS-HCC V28 HCC 20 (Lung and Other Severe Cancers). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM C22.2: Hepatoblastoma

C22.2 maps to CMS-HCC V28 20. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupC22.2Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of digestive organs (C15-C26)

C22.2

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Hepatoblastoma

A type of liver cancer that primarily affects infants and young children, arising from immature liver cells. It is the most common liver cancer in children.

Buddy Insight

Hepatoblastoma is the most common primary liver malignancy in children, typically presenting before age 3.

CMS-HCC V28

Mapped

HCC 20

Lung and Other Severe Cancers

Code-level coefficient reference

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 009

HHS-HCC 009 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 9

Lung and Other Severe Cancers

Code-level coefficient reference

RXHCC

Mapped

HCC 20

Lung, Kidney, and Other Cance...

Code-level coefficient reference

Code Book Path

Official

C22Malignant neoplasm of liver and intrahepatic bile ducts

C22.2Hepatoblastoma

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C22.2 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C22.2 in this effective period.

Related Child Codes

Official

C22.0Liver cell carcinoma

C22.1Intrahepatic bile duct carcinoma

C22.3Angiosarcoma of liver

C22.4Other sarcomas of liver

C22.7Other specified carcinomas of liver

Includes

Official

ICD-10-CM does not list Includes notes for C22.2 in this effective period.

Excludes 1

Official

malignant neoplasm of biliary tract NOS (C24.9)
secondary malignant neoplasm of liver and intrahepatic bile duct (C78.7)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C22.2 in this effective period.

Use Additional

Official

code to identify:
alcohol abuse and dependence (F10.-)
hepatitis B (B16.-, B18.0-B18.1)
hepatitis C (B17.1-, B18.2)

Code Also

Official

ICD-10-CM does not list Code Also instructions for C22.2 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Pathological confirmation of hepatoblastoma histology

Patient age (predominantly pediatric; adult cases are extremely rare)

Alpha-fetoprotein level (typically markedly elevated)

PRETEXT staging or equivalent

MEAT Support

HCC Buddy guidance

Pathological confirmation of hepatoblastoma histology

Patient age (predominantly pediatric; adult cases are extremely rare)

Alpha-fetoprotein level (typically markedly elevated)

PRETEXT staging or equivalent

Audit Caution

HCC Buddy guidance

Coding hepatoblastoma as hepatocellular carcinoma — these are histologically and clinically distinct entities

Using an unspecified liver cancer code when pathology clearly identifies hepatoblastoma

Not recognizing hepatoblastoma in the rare adult patient presentation

Failing to code associated genetic syndromes that may be relevant for family counseling

Common Mistakes

HCC Buddy guidance

C22.0 — Hepatocellular carcinoma: occurs in adults; hepatoblastoma is the pediatric counterpart with different histology

C22.8 — Primary liver cancer, unspecified type: use C22.2 when hepatoblastoma is pathologically confirmed

C96.A — Histiocytic sarcoma: rare pediatric liver tumor that may be confused with hepatoblastoma

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 C22.2 an HCC code?

Yes. C22.2 (Hepatoblastoma) 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: C22.2 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: C22.2
Description: Hepatoblastoma
HCC (V28): HCC 20 — Lung and Other Severe Cancers
RAF reference coefficient: 1.136
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 20, Lung and Other Severe Cancers

1.136

ESRDHCC 9, Lung and Other Severe Cancers

Not separately weighted

RxHCCHCC 20, Lung, Kidney, and Other Cancers; Secondary Cancer of Lymph Nodes and Other Sites

Not separately weighted

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 C22.2 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for C22.2

For C22.2 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 C22.2 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

C22.2 is the ICD-10-CM diagnosis code for hepatoblastoma. A type of liver cancer that primarily affects infants and young children, arising from immature liver cells. It is the most common liver cancer in children. C22.2 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, C22.2 maps to Lung and Other Severe Cancers (HCC 20) with a source-labeled community, non-dual, aged reference coefficient of 1.136. No V24 mapping is shown for C22.2; use the applicable model and payment year when reviewing the V28 mapping. 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. 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.

Verify patient age documentation; this diagnosis is almost exclusively in pediatric patients. Because C22.2 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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 C22.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify patient age documentation; this diagnosis is almost exclusively in pediatric patients
•Document any associated syndromes or genetic conditions if present

Clinical Significance

Hepatoblastoma is the most common primary liver malignancy in children, typically presenting before age 3. It is a rare embryonal tumor with a generally better prognosis than adult liver cancers when diagnosed and treated early. Risk adjustment capture is important because treatment involves complex multimodal therapy including neoadjuvant chemotherapy, surgical resection, and potential liver transplantation, all requiring specialized pediatric oncology care.

Documentation Requirements

✓Pathological confirmation of hepatoblastoma histology
✓Patient age (predominantly pediatric; adult cases are extremely rare)
✓Alpha-fetoprotein level (typically markedly elevated)
✓PRETEXT staging or equivalent
✓Any associated genetic syndromes (Beckwith-Wiedemann, familial adenomatous polyposis)

Commonly Confused Codes

•C22.0: Hepatocellular carcinoma: occurs in adults; hepatoblastoma is the pediatric counterpart with different histology
•C22.8: Primary liver cancer, unspecified type: use C22.2 when hepatoblastoma is pathologically confirmed
•C96.A: Histiocytic sarcoma: rare pediatric liver tumor that may be confused with hepatoblastoma