What ICD-10 Codes are Used for Mouth Sores?
Specific ICD-10-CM codes classify mouth sores, oral ulcers, or stomatitis. Here are ten commonly used codes for Mouth sores, along with brief clinical descriptions:
K12.0 - Recurrent aphthous stomatitis: Used for recurrent mouth ulcers, also known as canker sores, without other specified causes.
K12.1 - Other forms of stomatitis: Applied when there are mouth sores due to other causes not classified elsewhere.
K12.2 - Cellulitis and abscess of mouth: Utilized for mouth sores associated with cellulitis or abscess formation.
K12.3 - Oral mucositis (ulcerative): For ulcerative oral mucositis, it is often associated with chemotherapy or radiation therapy.
K12.8 - Other specified diseases of the mouth: Used for mouth sores related to specific diseases or conditions not covered by other codes.
K12.9 - Disease of the mouth, unspecified: Applied when the cause of mouth sores is unspecified or unknown.
B07.9 - Viral warts, unspecified: This code may apply if viral warts cause mouth sores.
K05.1 - Chronic gingivitis: Used when mouth sores are a symptom of chronic gingivitis.
K11.1 - Hypertrophy of salivary glands: This code can be applied if mouth sores result from hypertrophy of salivary glands.
K12.30 - Recurrent oral aphthae, unspecified: For recurrent, unspecified mouth ulcers without other specified causes.
Which Mouth Sore ICD Codes are Billable?
The billable status of the mentioned ICD-10 codes for Mouth Sores varies:
K12.0 - Recurrent aphthous stomatitis: Yes, billable. Medical expenses related to the diagnosis and treatment of recurrent aphthous stomatitis can be claimed.
K12.1 - Other forms of stomatitis: Yes, billable. Mouth sores due to causes not classified elsewhere are eligible for reimbursement.
K12.2 - Cellulitis and abscess of mouth: Yes, billable. Expenses associated with mouth sores linked to cellulitis or abscess formation can be claimed.
K12.3 - Oral mucositis (ulcerative): Yes, billable. This code covers ulcerative oral mucositis, often associated with chemotherapy or radiation therapy.
K12.8 - Other specified diseases of the mouth: Yes, billable. Mouth sores related to specific diseases or conditions not covered by other codes can be reimbursed.
K12.9 - Disease of the mouth, unspecified: Yes, billable. Expenses for diagnosing and treating mouth sores with an unspecified or unknown cause can be claimed.
B07.9 - Viral wart, unspecified: Yes, billable. If viral warts cause mouth sores, this code may be used for reimbursement.
K05.1 - Chronic gingivitis: Yes, billable. Mouth sores as a symptom of chronic gingivitis can be claimed.
K11.1 - Hypertrophy of salivary glands: Yes, billable. Expenses for treating mouth sores resulting from salivary gland hypertrophy can be reimbursed.
K12.30 - Recurrent oral aphthae, unspecified: Yes, billable. Medical expenses related to diagnosing and treating recurrent, unspecified mouth ulcers can be claimed.
- A mouth sore, or oral ulcer, is a painful lesion that can occur inside the mouth on the lips, cheeks, gums, tongue, or palate.
- Common causes of mouth sores include trauma (e.g., biting, dental work), viral infections (e.g., herpes simplex), and aphthous ulcers (canker sores).
- Assessment involves examining the sore's location, size, appearance, and duration, along with patient history.
- Sometimes, diagnostic tests, such as viral cultures or biopsies, may be needed to determine the underlying cause.
- Treatment options vary depending on the cause and may include topical medications, oral rinses, or antiviral drugs.
- Pain management is an essential aspect of care, often achieved with topical anesthetics or over-the-counter pain relievers.
- Patients should be educated on oral hygiene and encouraged to avoid irritants like tobacco and spicy foods.
- Follow-up is essential to monitor healing and identify any recurrence or persistent sores.
- Healthcare practitioners should consider underlying systemic conditions in cases of recurrent or atypical mouth sores.
- Referral to specialists, such as oral surgeons or dermatologists, may be necessary for complex or refractory cases.
- Oral Ulcer
- Canker Sore
- Aphthous Ulcer
- Mouth Lesion