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ICD-10 Guide
ICD-10 CodesC06.89

C06.89

Billable

Malignant neoplasm of overlapping sites of other parts of mouth

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 C06.89 is a billable code used to indicate a diagnosis of malignant neoplasm of overlapping sites of other parts of mouth.

Key Diagnostic Point:

C06.89 refers to malignant neoplasms that occur in overlapping sites of the oral cavity, which may include areas such as the gums, tongue, and other parts of the mouth that do not fall into more specific categories. These neoplasms can arise from various cell types, including squamous cells, and may present with symptoms such as lesions, ulcers, or swelling. Diagnosis typically involves a combination of clinical examination, imaging studies, and biopsy to confirm malignancy. Treatment often requires a multidisciplinary approach, including surgical intervention, radiation therapy, and chemotherapy, depending on the stage and location of the tumor. Dental considerations are crucial, as oral health can significantly impact treatment outcomes and quality of life for patients. Regular dental evaluations and management of oral complications are essential components of care for these patients.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in tumor location and presentation
  • Need for precise documentation of overlapping sites
  • Potential for multiple malignancies in the oral cavity
  • Interdisciplinary communication required for treatment planning

Audit Risk Factors

  • Inadequate documentation of tumor location
  • Failure to specify overlapping sites
  • Lack of interdisciplinary notes in patient records
  • Misclassification of benign versus malignant lesions

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed pathology reports, imaging studies, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with oral lesions that require biopsy and subsequent treatment planning.

Billing Considerations

Ensure that all treatment modalities are documented, including surgery, chemotherapy, and radiation.

Dentistry

Documentation Requirements

Comprehensive dental evaluations and management plans for oral health during cancer treatment.

Common Clinical Scenarios

Management of oral complications such as mucositis or xerostomia in patients undergoing cancer treatment.

Billing Considerations

Coordination with oncologists to manage oral health effectively during treatment.

Coding Guidelines

Inclusion Criteria

Use C06.89 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the site and type of malignancy
  • Include any relevant staging information and treatment details

Exclusion Criteria

Do NOT use C06.89 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

19301CPT Code

Excision, malignant skin lesion

Clinical Scenario

Used when excising a malignant lesion in the oral cavity.

Documentation Requirements

Document the size, location, and type of lesion excised.

Specialty Considerations

Oncologists and oral surgeons should coordinate documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of oral cavity malignancies, improving data accuracy and treatment tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of oral cavity malignancies, improving data accuracy and treatment tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of oral cavity malignancies, improving data accuracy and treatment tracking.

Resources

Clinical References

  • •
    American Cancer Society - Oral Cancer

Coding & Billing References

  • •
    American Cancer Society - Oral Cancer

Frequently Asked Questions

What are the common symptoms of malignant neoplasms in the oral cavity?

Common symptoms include non-healing sores, lumps, difficulty swallowing, and changes in speech. Patients may also experience pain or swelling in the affected areas.