C45.1: Mesothelioma of peritoneum
C45.1 is a billable, specific ICD-10-CM code for mesothelioma of peritoneum. It is valid for submission on a claim.
Check C45.1 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- other malignant neoplasm of soft tissue of peritoneum (C48.-)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Mesothelioma of cul-de-sac
- Mesothelioma of mesentery
- Mesothelioma of mesocolon
- Mesothelioma of omentum
- Mesothelioma of peritoneum (parietal) (pelvic)
Other codes that can never be billed with C45.1
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
C45.1 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 19 Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers1.798 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
C45.1 is named in 56 Medicare coverage policies: 56 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52370Billing and Coding: Bevacizumab and biosimilars
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52479Oral Anticancer Drugs - Policy Article
- A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
Alphabetic index entries that lead here
- Mesothelioma›site classification›mesentery
- Mesothelioma›site classification›mesocolon
- Mesothelioma›site classification›omentum
- Mesothelioma›site classification›peritoneum
Code history
Unchanged in every release from FY2024 to FY2027.