2025 ICD-10-CM code K11.3
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Digestive System - Diseases of oral cavity and salivary glands Diseases of the digestive system Feed
Abscess of salivary gland.
Modifiers may be applicable depending on the circumstances of the service, such as the location or the type of anesthesia used.Refer to the most current coding guidelines.
Medical necessity for treatment of a salivary gland abscess is established by the presence of localized infection characterized by pain, swelling, erythema, and potential systemic symptoms (fever, chills).The need for incision and drainage or antibiotic therapy is determined based on the severity and extent of the infection.
The clinical responsibility for this code falls under various specialties, primarily Oral and Maxillofacial Surgery, Dentistry, and potentially Infectious Disease specialists depending on the complexity and contributing factors.Management may involve incision and drainage, antibiotic therapy, and addressing underlying causes.
In simple words: This code is for an infection (abscess) in one of the salivary glands in your mouth.It’s important to specify which gland is affected and any other health problems that might be involved.
This code signifies an abscess located within a salivary gland.It requires further coding to specify the affected gland (e.g., parotid, submandibular, sublingual) and may necessitate additional codes to indicate contributing factors such as alcohol abuse, tobacco use, or other underlying conditions.
Example 1: A 45-year-old male presents with severe pain and swelling in the submandibular region, accompanied by fever and erythema. Clinical examination reveals a fluctuant mass consistent with a submandibular salivary gland abscess.The abscess is incised and drained, and the patient is started on antibiotics., A 60-year-old female with a history of Sjogren's syndrome experiences recurrent swelling and pain in her parotid glands.She presents with a fluctuant mass in the right parotid gland, indicative of an abscess.Treatment includes incision and drainage, along with management of her underlying autoimmune condition., A 22-year-old male with a history of intravenous drug use develops an abscess in his sublingual salivary gland.The infection is severe, requiring intravenous antibiotics and close monitoring for potential complications.
Detailed clinical history including pain onset, duration, character, location, associated symptoms (fever, chills, trismus), and any relevant medical history (e.g., Sjogren's syndrome, diabetes). Physical examination findings detailing the location, size, and characteristics of the abscess (e.g., fluctuant, erythematous).Imaging studies (e.g., ultrasound, CT scan) to confirm the diagnosis and assess the extent of the infection.Results of any laboratory tests (e.g., complete blood count, culture and sensitivity). Documentation of the treatment provided (e.g., incision and drainage, antibiotic therapy).
** This code is for an abscess specifically within a salivary gland.It does not include abscesses in other areas of the oral cavity.
- Payment Status: Active
- Modifier TC rule: The application of technical component (TC) modifiers depends on the specific services rendered.Refer to the most current coding guidelines for the relevant procedures.
- Specialties:Oral and Maxillofacial Surgery, Dentistry, Infectious Disease
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Emergency Room - Hospital, Ambulatory Surgical Center