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{
"id" : "fibrosis_score_38658",
"algorithm" : "eod_public",
"version" : "1.0",
"name" : "Fibrosis Score",
"title" : "Fibrosis Score",
"notes" : "**Note 1:** Physician statement of fibrosis score can be used to code this data item when no other information is available. However, code 7 when the physician statement of fibrosis score is not based on histologic examination of the liver.\n\n**Note 2:** AJCC 8th edition chapter 22 (Liver) and the CAP protocol for Hepatocellular Carcinoma use the term “fibrosis score.” Chapter 23 (Intrahepatic Bile Ducts) describes it as “nontumoral hepatic parenchymal fibrosis/cirrhosis.” Both AJCC and CAP recommend the Ishak Score system. Ishak uses a scale of 0-6 with 6 indicating cirrhosis. Other pathological scoring systems in use include the Batts-Ludwig system, which uses scores of 0-4, and the METAVIR system which uses scores of F0-F4.\n\n**Note 3:** FIB-4 is NOT a pathological fibrosis score of 4. It is a scoring method using the patient’s age and relevant lab values to calculate a score. The medical record may show something like “FIB-4 = 3.52.” Do not code FIB-4 values in this data item.\n\n**Note 4:** AJCC classifies Ishak fibrosis scores 0-4 (none to moderate fibrosis) as F0, and Ishak fibrosis scores 5-6 (cirrhosis/severe fibrosis) as F1. This is not the same as METAVIR score F0 or F1.\n\n**Note 5:** If a fibrosis score is stated but the scoring system is not recorded, consult with the physician. If no further information is available, code 9.",
"last_modified" : "2018-03-12T16:39:56.705Z",
"definition" : [ {
"key" : "fibrosis_score",
"name" : "Code",
"type" : "INPUT"
}, {
"key" : "description",
"name" : "Description",
"type" : "DESCRIPTION"
} ],
"rows" : [ [ "0", "Ishak fibrosis score 0-4\n\nNo to moderate fibrosis\nMETAVIR score F0-F3\nBatt-Ludwig score 0-3" ], [ "1", "Ishak fibrosis score 5-6\n\nAdvanced/severe fibrosis\nMETAVIR score F4\nBatt-Ludwig score 4\nDeveloping cirrhosis\nIncomplete cirrhosis\nTransition to cirrhosis\nCirrhosis, probable or definite\nCirrhosis, NOS" ], [ "7", "Clinical statement of advanced/severe fibrosis or cirrhosis, AND\nNot histologically confirmed or unknown if histologically confirmed" ], [ "8", "Not applicable: Information not collected for this case\n(If this item is required by your standard setter, use of code 8 will result in an edit error.)" ], [ "9", "Not documented in medical record\nStated in medical record that patient does not have advanced cirrhosis/advanced fibrosis, not histologically confirmed or unknown if histologically confirmed\nFibrosis score stated but cannot be assigned to codes 0 or 1\nFibrosis score stated but scoring system not recorded\nFibrosis Score not assessed or unknown if assessed" ] ]
}
