Program Operations Manual System (POMS)
TN 32 (08-20)
COMPASSIONATE ALLOWANCES INFORMATION
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HEPATOBLASTOMA
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ALTERNATE NAMES
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Pediatric Embryonal Hepatoma; Pediatric Hepatoblastoma; Liver Cancer – children; HB;
HBL
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DESCRIPTION
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Hepatoblastoma (HB) is a type of liver tumor that usually affects children younger than 3 years. It is
very rarely diagnosed in adolescence and is exceedingly rare in adults. If older children
and adults have this disease, the prognosis tends to be worse than in younger children.
The cause of HB is generally unknown. Cirrhosis is not associated with this tumor. A common presentation in children is an asymptomatic
abdominal mass.
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DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND
ICD-9-CM/ICD-10-CM
CODING
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Diagnostic
testing: The diagnosis of HB is established by:
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CBC count with differential;
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Abdominal radiography/ultrasonography;
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Positron emission tomography (PET) scans;
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Physical
findings:
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Swollen abdomen (belly) with a large mass;
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Other symptoms may include:
ICD-9:
155.0
ICD-10: C22.2
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PROGRESSION
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Staging of HB is based on the degree of surgical resection, histologic evaluation,
and presence of metastatic disease. The most common sites for metastasis or spread
of tumor are the lungs and abdominal lymph nodes.
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TREATMENT
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Treatment options include chemotherapy, radiotherapy, surgery to remove the tumor,
and liver transplantation. When the tumor is determined to be non-resectable and there
are no metastases, liver transplantation is the treatment of choice.
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SUGGESTED PROGRAMMATIC ASSESSMENT*
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Suggested MER for Evaluation:
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Clinical history and examination that describes the diagnostic features of the impairment;
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Imaging test results; and
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Suggested Listings for Evaluation:
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DETERMINATION
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LISTING
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REMARKS
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Meets
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13.19
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Hepatoblastoma occurs primarily in children. Hepatoblastoma meets listing 13.19 upon
confirmed diagnosis, regardless of the effectiveness of treatment.
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113.03
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Hepatoblastoma occurs primarily in children. Hepatoblastoma meets the criteria in
listing 113.03 upon confirmed diagnosis, regardless of the effectiveness of treatment.
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Equals
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* 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.
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