C00-C14 — Malignant neoplasms of lip, oral cavity and pharynx
ICD-10-CM codes C00-C14 cover malignant neoplasms of lip, oral cavity and pharynx, within neoplasms. The block holds 78 codes across 15 categories, of which 65 are billable and 13 are header codes that cannot be submitted on a claim.
Risk adjustment in C00-C14
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 21 Lymphoma and Other Cancers
What else to watch in C00-C14
- 65 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.
Categories in C00-C14
- C00Malignant neoplasm of lip
- C01Malignant neoplasm of base of tongue
- C02Malignant neoplasm of other and unspecified parts of tongue
- C03Malignant neoplasm of gum
- C04Malignant neoplasm of floor of mouth
- C05Malignant neoplasm of palate
- C06Malignant neoplasm of other and unspecified parts of mouth
- C07Malignant neoplasm of parotid gland
- C08Malignant neoplasm of other and unspecified major salivary glands
- C09Malignant neoplasm of tonsil
- C10Malignant neoplasm of oropharynx
- C11Malignant neoplasm of nasopharynx
- C12Malignant neoplasm of pyriform sinus
- C13Malignant neoplasm of hypopharynx
- C14Malignant neoplasm of other and ill-defined sites in the lip, oral cavity and pharynx