C22.3 ICD-10-CM Code: Angiosarcoma of liver
C22.3 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)
C22.3
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAngiosarcoma of liver
A rare cancer of the blood vessels in the liver that develops from the cells lining these vessels. It is highly aggressive and often associated with exposure to certain chemicals or radiation.
Buddy Insight
Angiosarcoma of the liver is one of the rarest and most aggressive primary liver malignancies, arising from the endothelial cells of hepatic blood vessels.
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- Kupffer cell sarcoma
Excludes 2
Official- gastrointestinal stromal tumors (C49.A-)Inherited from C15-C26
Related Codes
Includes
OfficialNo Includes notes are included in this display for C22.3. 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 C22.3. 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 C22.3. 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 C22.3 an HCC code?
Yes. C22.3 (Angiosarcoma of liver) 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: C22.3 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
- C22.3
- Description
- Angiosarcoma of liver
- 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 C22.3 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for C22.3
For C22.3, 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
C22.3 is the ICD-10-CM diagnosis code for angiosarcoma of liver. A rare cancer of the blood vessels in the liver that develops from the cells lining these vessels. It is highly aggressive and often associated with exposure to certain chemicals or radiation. C22.3 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, C22.3 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 C22.3; use the applicable model and payment year when reviewing the V28 mapping. 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.
Document any history of vinyl chloride, thorotrast, or radiation exposure. For C22.3, 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 C22.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document any history of vinyl chloride, thorotrast, or radiation exposure
- •Distinguish from other sarcomas of liver (C22.4) by confirming angiosarcoma histology
Clinical Significance
Angiosarcoma of the liver is one of the rarest and most aggressive primary liver malignancies, arising from the endothelial cells of hepatic blood vessels. It has a known association with occupational exposure to vinyl chloride, thorium dioxide (Thorotrast), and arsenic. The prognosis is extremely poor, with most patients surviving less than six months after diagnosis. Accurate coding captures the high resource utilization for this rapidly progressive malignancy.
Documentation Requirements
- ✓Pathological confirmation of angiosarcoma histology (vascular endothelial origin)
- ✓History of toxic exposure (vinyl chloride, Thorotrast, arsenic, radiation)
- ✓Stage of disease and extent of hepatic involvement
- ✓Distinction from other hepatic sarcomas
- ✓Treatment approach and palliative care needs
Commonly Confused Codes
- •C22.4: Other sarcomas of liver: angiosarcoma has its own specific code; use C22.4 for non-angiosarcoma sarcomas (leiomyosarcoma, fibrosarcoma)
- •C22.0: Hepatocellular carcinoma: different cell origin; angiosarcoma is vascular, hepatocellular carcinoma is hepatocyte
- •C49.4: Connective tissue of abdomen: soft tissue sarcomas outside the liver have different codes