C22.3
BillableAngiosarcoma of liver
HCC Category Mapping
V28HCC 20 — Lung and Other Severe Cancers
0.000V24HCC 9 — Lung and Other Severe Cancers
0.973ESRDHCC 9 — Lung and Other Severe Cancers
0.000RxHCCHCC 20 — Cancer, Liver and Intrahepatic Bile Duct
0.000What This Code Means
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.
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 hepatocyteC49.4 — Connective tissue of abdomen: soft tissue sarcomas outside the liver have different codes