![]() ![]() ![]() Further validation of extended HCC-LT criteria models and pre-LT treatment strategies are required.ĭown staging Expanded criteria Hepatocellular carcinoma Liver transplantation Locoregional therapy Milan criteria. The ongoing discrepancy between organ demand and supply makes patient selection the most challenging element of organ allocation. Molecular signatures of HCC have also been correlated to outcomes these have yet to be incorporated into HCC-LT selection criteria formally. Similarly, tumor marker levels as response to LRT has been utilized as surrogate of tumor biology. Post-LRT monitoring aims to identify candidates with favorable tumor behavior. HCC that presents beyond MC initially can be downstaged with locoregional therapy (LRT). Morphometric expansions on MC as well as various criteria which incorporate biomarkers as surrogates of tumor biology have been described. Supporting documentation of how the physician monitored, evaluated, assessed or treated the patient’s HCC diagnosis must be in the record for compliant coding. 1999).Meaningful improvement in treatment outcomes has only occurred in recent decades, with the incidence-to-mortality ratio for HCC approaching one prior to this (El-Serag 2001). Using MEAT criteria ensures proper documentation for HCC diagnoses and only one element of each MEAT criteria documented satisfies the documentation requirement for an HCC diagnosis. This has led to the development of numerous expanded criteria worldwide. Hepatocellular carcinoma (HCC) is the fifth most common human cancer with a historically poor prognosis (Bosch et al. This study compared the long-term survival of patients beyond the Milan criteria who received SR or LT. After initially dismal outcomes, the Milan criteria (MC) (single HCC ≤ 5 cm or up to 3 HCCs ≤ 3 cm) have been adopted worldwide to select HCC patients for LT, however cumulative experience has shown that MC can be too strict. Background: Increasing studies have suggested that surgical resection (SR) or liver transplantation (LT) could bring survival benefits for patients with hepacelluar carcinoma (HCC) beyond Milan criteria. Published by Elsevier Ltd.Liver transplantation (LT) for hepatocellular carcinoma (HCC) has been established as a standard treatment in selected patients for the last two and a half decades. Hepatocelluar carcinoma Liver transplantation Prognosis Propensity scoring matching Surgical resection.Ĭopyright © 2017. The MEAT acronym can be used as a valuable general guideline for physicians and auditors, but there is no official regulation to substantiate the use of this. Over time, patient’s chronic condition(s) may be overlooked, assumed or tacitly understood. The SOAP format addresses patient’s complaint in an organized and consistent manner. ![]() If physicians understand the MEAT framework, they can accomplish HCC. HCC Coding Help Doctors Document the Right Conditions. Our propensity model suggested that LT provided significantly better long-term survival than SR for HCC beyond Milan criteria before and after PSM. Does your Documentation have MEAT Due to its simplicity and popularity, many medical records take on the SOAP format: Subject, Objective, Assessment and Plan. To ensure that diagnosis captures the accurate HCC code, healthcare providers should adhere to the M.E.A.T criteria. Transplantation was a favorable factor associated with prognosis before and after propensity score matching (HR 2.643). For patients with smaller tumor size, the 1-, 3-, and 5-year OS rates were 78.3, 66.7, and 66.7% for group LT, and 83.8, 42.6, and 18.6% for group SR, p = 0.009). In subgroup analysis, for patients with lower AFP level, the 1-, 3-, and 5-year OS rates for the two groups were significantly different (86.7, 71.9, and 71.9% for group LT vs. Prognosis was significantly better for the LT group than the SR group before (P < 0.001) and after PSM(p = 0.003). Notice that all the criteria are past-tense, meaning all must be done. The best way to streamline the documentation process and make it up-to-par for HCC coding is to ALWAYS include MEAT (monitored, evaluated, assessed/addressed, and treated) in the patient medical records for each encounter. Analysis was performed using propensity score matching (PSM), the Kaplan-Meier method and the Cox proportional hazards model. Streamlined HCC coding using MEAT criteria. This study compared the long-term survival of patients beyond the Milan criteria who received SR or LT.Ī total of 461 HCC patients were retrospectively collected. Increasing studies have suggested that surgical resection (SR) or liver transplantation (LT) could bring survival benefits for patients with hepacelluar carcinoma (HCC) beyond Milan criteria. ![]()
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