Program Operations Manual System (POMS)
TN 45 (08-21)
DI 23022.266 Pericardial Mesothelioma
COMPASSIONATE ALLOWANCES INFORMATION
|
PERICARDIAL MESOTHELIOMA
|
ALTERNATE NAMES
|
Malignant Pericardial Mesothelioma; Primary Pericardial Mesothelioma; Primary Pericardial
Malignant Mesothelioma
|
DESCRIPTION
|
Pericardial Mesothelioma is a rare asbestos-related cancer that originates in the pericardium, the protective
membrane lining the heart. This type of mesothelioma is very rare, accounting for
less than 1 percent of malignant mesothelioma cases.
Clinical symptoms and signs are frequently nonspecific, and the diagnosis is usually
made after surgery or at autopsy.
This form of cancer is most often diagnosed in people between the ages of 50 and 70,
with the median age being 55. Approximately 60 percent of cases occur in men.
Due to its rarity and nonspecific symptoms, it is usually diagnosed late when the
disease burden is extensive.
|
DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM/ICD-10-CM
CODING
|
Diagnostic testing: The diagnosis of pericardial mesothelioma is made by a combination of :
-
•
Physical examination and medical history;
-
-
-
-
Physical findings:
-
•
Compression of the heart by fluid;
-
•
Inflammation of the pericardium;
-
-
-
-
-
•
Unusual lumps of tissue under the skin of the chest;
-
•
Unexplained weight loss; and
-
ICD-9: 164.1
ICD-10: C45.2
|
PROGRESSION
|
The prognosis for individuals with this cancer is the poorest of all forms of mesothelioma.
The survival time for patients following their initial showing of symptoms is often
less than six months.
|
TREATMENT
|
There is no standard treatment for pericardial mesothelioma. The treatment options
include surgery, chemotherapy, radiotherapy, immunotherapy, or pericardiectomy (surgical
procedure involving the partial or whole removal of the pericardium). Because most
cases are diagnosed at later stages, these treatment are often palliative.
|
SUGGESTED PROGRAMMATIC ASSESSMENT*
|
Suggested MER for Evaluation:
-
-
•
Pathology report confirming a diagnosis of pericardial mesothelioma.
|
Suggested Listings for Evaluation:
|
DETERMINATION
|
LISTING
|
REMARKS
|
Meets
|
|
|
Equals
|
13.15 A
|
|
* Adjudicators may, at their discretion, use the Medical Evidence of Record or the
listings suggested to evaluate the claim. However, the decision to allow or deny the
claim rests with the adjudicator.
|