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Malignant Neoplasm of the Liver B032

Last amended 
26 June 2015
Current RMA Instruments:
Reasonable Hypothesis SOP
21 of 2011
Balance of Probabilities SOP
22 of 2011
Changes from Previous Instruments:

SOP Bulletin 149

ICD Coding:
  • ICD-9-CM Codes: 155.0
  • ICD-10-AM Codes: C22.0

Is specific diagnostic evidence required to apply the SOP?Yes.

Information on the histological type is required.  Note the excluded conditions, listed below.  The liver is a common site for secondary/metastatic cancer.  Ensure the claimed condition is a primary liver cancer before applying this SOP.

Are there sub-factors that require specific information? – No.
Diagnoses covered by SOP
  • hepatocellular carcinoma
  • hepatoblastoma
  • hepatocarcinoma
  • liver cell carcinoma
  • malignant hepatoma
  • malignant teratoma of the liver
Conditions excluded from SOP
  • carcinoma of an intrahepatic bile duct, ICD code 155.1
  • cholangiocarcinoma of the liver, ICD code 155.1
  • Hodgkin’s lymphoma of the liver, ICD code 201.9
  • non-Hodgkin’s lymphoma of the liver, ICD code 202.8
  • soft tissue sarcoma of the liver, ICD code 171.8
  • Secondary/metastatic cancer/carcinoma involving the liver (code to primary cancer site)
Unconfirmed diagnosis

If, after applying the above information, you are unable to confirm the diagnosis, you should then:

  1. seek medical officer advice about further investigation, or;
  2. generate a diagnostic report, or;
  3. re-encode the condition, if appropriate.

The following may be useful in establishing the diagnosis:

  • A report from a treating specialist;
  • A histopathology report.