C45.2
BillableMesothelioma of pericardium
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 cancer that develops in the membrane surrounding the heart (pericardium), usually caused by asbestos exposure.
Coding Tips
- •Pericardial mesothelioma is the rarest form; document any cardiac symptoms or pericardial effusion noted in clinical documentation
- •Confirm the diagnosis is mesothelioma and not metastatic disease to the pericardium from another primary cancer
Clinical Significance
Mesothelioma of the pericardium is the rarest form of mesothelioma, accounting for less than 1% of all mesothelioma cases. It arises from the serosal lining of the heart and may present with pericardial effusion, constrictive pericarditis, or cardiac tamponade. Prognosis is extremely poor, with most patients surviving less than 6 months from diagnosis.
Documentation Requirements
- ✓Histologic confirmation of pericardial mesothelioma — extremely rare and requires specialized pathologic confirmation
- ✓Imaging findings (echocardiogram, CT, or cardiac MRI showing pericardial thickening or effusion)
- ✓Asbestos exposure history if present (association is weaker than pleural mesothelioma)
- ✓Cardiac functional status and hemodynamic impact
- ✓Treatment plan (pericardectomy, systemic chemotherapy, palliative care)
- ✓Distinction from metastatic pericardial disease
Excludes 1 — Do NOT code together
- other malignant neoplasm of pericardium (C38.0)
Commonly Confused Codes
C45.0 — Mesothelioma of pleura; different serosal surfaceC45.1 — Mesothelioma of peritoneum; different serosal surfaceC38.0 — Malignant neoplasm of heart; for primary cardiac tumors (sarcomas), not pericardial mesotheliomaC79.89 — Secondary malignant neoplasm of other specified sites; for metastatic pericardial disease