2025 ICD-10-CM code C05.0
(Active) Effective Date: N/A Neoplasms - Malignant neoplasm of lip, oral cavity and pharynx (C00-C14) 2 Neoplasms (C00-D49) Feed
Malignant neoplasm of the hard palate.
Medical necessity is established by the presence of a malignant neoplasm confirmed by biopsy and imaging studies, impacting the patient's ability to speak, eat, or swallow.
A patient with malignant neoplasm of the hard palate may present with an ulcer (open sore) on the roof of the mouth, a mass in the neck, and enlarged lymph nodes. The patient may complain of ear pain, sore throat, and difficulty opening the mouth, chewing, and swallowing, with resulting weight loss. The ulcer at the palate may bleed, grow larger, and spread to adjacent tissues. Providers diagnose the condition based on the patient’s history and examination of the mouth, throat, and neck. The provider will biopsy the lesion and may perform fine needle aspiration or open biopsy of any palpable neck mass or lymph nodes. Imaging tests include X–rays, computerized tomography (CT) scans, magnetic resonance imaging (MRI), and positron emission tomography (PET) to diagnose and stage the malignancy.
In simple words: Cancer of the hard palate (the roof of your mouth).
Malignant neoplasm of the hard palate (roof of the mouth that separates the mouth and nasal cavity.) refers to a cancerous mass that can spread to other tissues. It is commonly found in older patients with poor oral hygiene or who are chain smokers, use snuff, or abuse alcohol. Previous exposure to human papillomavirus (HPV) and radiation also cause malignant neoplasm of the hard palate.
Example 1: A 65-year-old male with a history of smoking presents with a non-healing ulcer on the hard palate. Biopsy confirms squamous cell carcinoma., A 50-year-old female with HPV presents with a lesion on the hard palate. Biopsy reveals a malignant neoplasm., A 70-year-old male with a history of alcohol abuse develops a painful mass on the hard palate. Imaging and biopsy confirm malignancy.
Clinical findings, imaging reports (X-ray, CT, MRI, PET), biopsy results, and pathology reports.
- Specialties:Otolaryngology, Head and Neck Surgery, Oral Surgery, Oncology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Physician's Office