Hepatitis C A011

Current RMA Instruments

Changes from previous Instruments

ICD Coding:

• ICD-9-CM Codes: 070.41, 070.44, 070.51, 070.54
• ICD-10-AM Codes: B17.1, B18.2

Brief description

Hepatitis C is a viral infection of the liver.  The SOP covers acute, symptomatic hepatitis C infection, and chronic infection.  Acute infection is asymptomatic in around 85% of cases.  Acute infection resolves in about 25% of cases, with the rest going on to develop chronic hepatitis C.

Confirming the diagnosis

Diagnosis of acute hepatitis C requires the presence of an appropriate, symptomatic, clinical illness and confirmation by laboratory testing for serology or nucleic acid markers (HCV RNA).  Diagnosis of chronic hepatitis C requires evidence of infection of at least 6 months duration, confirmed by laboratory testing for nucleic acid markers (HCV RNA).

Additional diagnoses covered by SOP

• Non-A non-B hepatitis, an obsolete term – a pre-1990s diagnosis of non-A non-B hepatitis was very probably Hepatitis C

Conditions not covered by SOP

• Asymptomatic acute hepatitis C infection - not a disease or injury unless develops into chronic hepatitis C infection (> 6 months duration)
• Hepatitis A*
• Hepatitis B*
• Hepatitis D*
• Hepatitis E*

* Another SOP applies

Clinical onset

For acute symptomatic HCV infection, clinical onset will be when the symptoms of the clinical illness, subsequently confirmed to be acute HCV infection, first manifest.  For chronic HCV infection (in the absence of acute clinical infection) clinical onset will be when infection with HCV was first detected on laboratory testing.

Clinical worsening

Worsening of HCV infection will mainly be a consderation in cases of chronic infection. Chronic HCV infection typically has followed a progressive course over many years, ultimately resulting in cirrhosis, hepatocellular carcinoma, and the need for liver transplantation.  Modern therapy with antiviral agents can now effectively cure chronic HCV infection in almost all patients.