C45.0
BillableMesothelioma of pleura
HCC Category Mapping
V28HCC 19 — Lymphoma and Other Cancers
0.105V24HCC 9 — Lung and Other Severe Cancers
0.973ESRDHCC 9 — Lung and Other Severe Cancers
0.000RxHCCHCC 22 — Cancer, Other Specified Sites
0.000What This Code Means
A rare and aggressive cancer that develops in the thin layer of tissue covering the lungs (pleura), usually caused by asbestos exposure.
Coding Tips
- •Document any history of asbestos exposure in the patient record, as this is relevant for etiology and potential workers' compensation claims
- •Mesothelioma of pleura is the most common type; ensure you are not confusing this with lung cancer or other thoracic malignancies
Clinical Significance
Mesothelioma of the pleura is a highly aggressive cancer of the pleural lining, almost exclusively caused by asbestos exposure with a latency period of 20-50 years. Median survival is 12-18 months. This cancer carries one of the highest RAF weights in V24, reflecting its severity and resource intensity. Accurate coding requires distinguishing it from metastatic pleural disease.
Documentation Requirements
- ✓Histologic confirmation of mesothelioma (epithelioid, sarcomatoid, or biphasic subtype)
- ✓Asbestos exposure history
- ✓Laterality of pleural involvement (right vs. left, or bilateral)
- ✓Staging by International Mesothelioma Interest Group or AJCC criteria
- ✓Treatment plan (extrapleural pneumonectomy, pleurectomy/decortication, chemotherapy, immunotherapy)
- ✓Performance status and prognosis documentation
Excludes 1 — Do NOT code together
- other malignant neoplasm of pleura (C38.4)
Commonly Confused Codes
C34.x — Malignant neoplasm of lung (bronchus); lung cancer is parenchymal, mesothelioma is pleural — different diseases with different treatmentsC38.4 — Malignant neoplasm of pleura; used for non-mesothelioma pleural cancersC78.2 — Secondary malignant neoplasm of pleura; for metastatic disease to the pleura from other cancersC45.1 — Mesothelioma of peritoneum; different serosal surface