Updated on: July 23, 2025
Hepatic hemangiomas are the most common benign liver tumors—and while they’re often incidental findings, proper documentation and coding are still crucial for patient care continuity, reimbursement, and medico-legal accuracy.
This clinical guide covers everything you need to know about hepatic hemangiomas: their presentation, diagnosis, ICD-10 coding, and how tools like DocScrib simplify documentation at the point of care.
🔗 Learn how DocScrib saves time and ensures coding accuracy at DocScrib.com
What is a Hepatic Hemangioma?
A hepatic hemangioma (also called liver hemangioma) is a benign vascular tumor of the liver, made up of clusters of blood vessels. Most patients are asymptomatic, and the lesion is often discovered incidentally on ultrasound or CT scan.
Key Clinical Facts:
-
Prevalence: ~5% in the general population
-
More common in women (2:1 ratio)
-
Usually <5 cm, but some may grow >10 cm (“giant hemangiomas”)
-
Rarely requires intervention unless symptomatic or rapidly enlarging
Common Symptoms of Hepatic Hemangiomas
While most patients have no symptoms, larger hemangiomas or lesions near the liver capsule can cause:
-
Right upper quadrant discomfort or fullness
-
Nausea or early satiety
-
Palpable mass (rare)
-
Compression symptoms (e.g., bile ducts or IVC in giant cases)
🧠 Clinical Insight: Symptoms are typically nonspecific. Imaging is key to distinguishing hemangiomas from hepatic adenomas, focal nodular hyperplasia (FNH), or malignancies.
Diagnosing Hepatic Hemangiomas
Imaging Modalities
| Modality | Findings |
|---|---|
| Ultrasound | Hyperechoic, well-circumscribed lesion |
| CT Scan | Peripheral nodular enhancement, centripetal fill-in |
| MRI | Bright on T2-weighted images |
| 99mTc-Tagged RBC Scan | Reserved for complex or inconclusive cases |
⚠️ Biopsy is usually avoided due to bleeding risk unless malignancy cannot be ruled out by imaging.
ICD-10 Coding for Hepatic Hemangiomas
Accurate documentation helps prevent unnecessary workups and ensures proper coding in outpatient, inpatient, and imaging follow-up scenarios.
Relevant ICD-10 Code
| ICD-10 Code | Description |
|---|---|
| D18.01 | Hemangioma of liver (hepatic hemangioma) |
✅ Use D18.01 when the hemangioma is incidentally found or confirmed via imaging.
❌ Do not code as a liver mass (R16.0) unless the diagnosis is unclear.
Clinical Scenario: Incidental Hepatic Hemangioma
Patient: 58-year-old female undergoes abdominal ultrasound for evaluation of gallstones. Imaging reveals a 3.5 cm well-defined echogenic lesion in the right hepatic lobe, consistent with hemangioma.
DocScrib-Generated SOAP Note:
S: Patient asymptomatic, here for gallstone evaluation.
O: RUQ ultrasound shows 3.5 cm echogenic lesion in right hepatic lobe with features consistent with hemangioma.
A: Incidental hepatic hemangioma (D18.01). No concerning features.
P: Reassure patient. No treatment needed. Optional imaging in 6–12 months if large or patient concerned.
✅ ICD-10 auto-suggested
✅ Chart note EHR-ready
✅ Fully compliant documentation
When Should Hepatic Hemangiomas Be Monitored or Treated?
| Clinical Feature | Action |
|---|---|
| <5 cm, asymptomatic | No intervention; document and reassure |
| >5 cm or rapid growth | Consider follow-up imaging q6–12 months |
| Symptomatic (pain, compression) | Referral to hepatology/surgery for evaluation |
| Uncertain diagnosis on imaging | MRI or specialist consultation—biopsy rarely indicated |
| Coagulopathy or Kasabach-Merritt syndrome | Rare; needs urgent hematology referral |
Why Documenting Incidental Hemangiomas Properly Matters
| Reason | Clinical/Operational Benefit |
|---|---|
| Avoid unnecessary testing | Reduces duplicate imaging, radiation, and costs |
| Clear follow-up communication | Prevents anxiety and confusion for patients and future providers |
| Coding & billing compliance | Ensures appropriate CPT/ICD linkage in imaging reports |
| Risk adjustment & analytics | Distinguishes benign findings from suspicious liver pathology |
How DocScrib Transforms Documentation for Hepatic Lesions
DocScrib is an AI medical scribe that listens, understands, and automatically generates notes, ICD-10 codes, and diagnostic impressions based on your clinical encounters.
| Feature | Manual Workflow | With DocScrib |
|---|---|---|
| ICD-10 Selection | Prone to omissions | ✅ Suggested based on context |
| Lesion Classification | Manually typed | ✅ Recognizes imaging keywords |
| Radiology Report Summary | Copy-pasted manually | ✅ Auto-integrated into SOAP |
| Follow-up Planning | May be overlooked | ✅ Prompted based on size/symptoms |
| Time to Document | 7–10 minutes | ✅ Under 60 seconds |
🔗 Visit DocScrib to see how it works for hepatobiliary cases and beyond.
FAQs: Hepatic Hemangioma & ICD-10 Documentation
Q1: Can I ignore a hepatic hemangioma if it’s found incidentally?
Yes, in most cases—but you should still document it with ICD-10 code D18.01 and patient education.
Q2: Should every hepatic lesion be biopsied?
No. Hemangiomas are usually diagnosed via imaging. Biopsy is reserved for indeterminate or suspicious lesions.
Q3: How often should I repeat imaging for hemangiomas?
Only if the lesion is >5 cm, growing, or symptomatic. Otherwise, reassurance is sufficient.
Q4: Can DocScrib assist with radiology report interpretation?
Yes. DocScrib parses radiology findings and suggests relevant codes and note templates—making liver lesion documentation seamless.
Final Thoughts: Small Lesion, Big Documentation Value
While hepatic hemangiomas are often benign and silent, the way we document them is far from trivial. Proper classification and coding help avoid unnecessary follow-ups, reduce patient anxiety, and ensure clarity across the care continuum.
With DocScrib, you can: