C45 - Mesothelioma

Clinical Information

• Mesothelioma-. a tumor derived from mesothelial tissue (peritoneum, pleura, pericardium). it appears as broad sheets of cells, with some regions containing spindle-shaped, sarcoma-like cells and other regions showing adenomatous patterns. pleural mesotheliomas have been linked to exposure to asbestos. (dorland, 27th ed)
• Mesothelioma, Cystic-. a peritoneal mesothelioma affecting mainly young females and producing cysts of variable size and number lined by a single layer of benign mesothelial cells. the disease follows a benign course and is compatible with a normal life expectancy, requiring occasionally partial excision or decompression for relief of pain or other symptoms. malignant potential is exceptional. (from holland et al., cancer medicine, 3d ed, p1345)
• Mesothelioma, Malignant-. a type of mesothelioma with a tendency to metastasize. most tumors originate from either the pleura or peritoneum, tumors may also originate in the pericardium or testicular tissue. it is associated with asbestos exposure. somatic mutations identified in wt1, bcl10, cdkn2a, nf2, and bap1 genes are associated with the malignancy. omim: 156240.
• Solitary Fibrous Tumor, Pleural-. a rare neoplasm, usually benign, derived from mesenchymal fibroblasts located in the submesothelial lining of the pleura. it spite of its various synonyms, it has no features of mesothelial cells and is not related to malignant mesothelioma or asbestos exposure.

Specific Coding for Mesothelioma

Non-specific codes like C45 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for mesothelioma:

Patient Education

Mesothelioma

The tissue that lines your lungs, stomach, heart, and other organs is called mesothelium. Mesothelioma, also known as malignant mesothelioma, is cancer of that tissue. It usually starts in the lungs, but can also start in the abdomen or other organs.

Malignant mesothelioma is rare but serious. Most people who get it have worked on jobs where they inhaled asbestos particles. After being exposed to asbestos, it usually takes a long time for the disease to form.

Symptoms include:

• Trouble breathing
• Pain under the rib cage
• Pain, swelling, or lumps in the abdomen
• Weight loss for no known reason

Sometimes it is hard to tell the difference between malignant mesothelioma and lung cancer. Your doctor uses imaging tests and a biopsy to make the diagnosis. Malignant mesothelioma is often found when it is advanced. This makes it harder to treat. Treatment may include surgery, radiation, chemotherapy, and/or targeted therapy. Targeted therapy uses drugs or other substances that attack specific cancer cells with less harm to normal cells.

NIH: National Cancer Institute

Code History

• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)