2025 ICD-10-CM code K13.7
Other and unspecified lesions of oral mucosa.
Medical necessity for using this code rests on the presence of a lesion affecting the oral mucosa that requires evaluation and/or treatment. The documentation should support the need for intervention.
Diagnosis and management of conditions affecting the oral mucosa is typically the responsibility of dentists, oral surgeons, or otolaryngologists.They may perform biopsies or other diagnostic tests to identify the specific lesion.
- Diseases of the digestive system (K00-K95)
- K13 - Other diseases of lip and oral mucosaK13.7 - Other and unspecified lesions of oral mucosa
In simple words: This code is used when there are changes or damage to the moist skin-like lining inside your mouth that aren't covered by more specific codes.
This code encompasses lesions of the oral mucosa that are not otherwise specified.The oral mucosa refers to the mucous membrane lining the inside of the mouth.
Example 1: A patient presents with white patches on the oral mucosa that are not identified as any specific condition. The physician documents these lesions as "unspecified lesions of oral mucosa.", A patient with a history of chewing tobacco develops a non-cancerous lesion on the inside of their cheek.Biopsy results are inconclusive.The lesion is coded as "other lesion of oral mucosa.", A patient experiences irritation and a small ulcer on the inner lip after accidentally biting it. This lesion, not meeting the criteria for a specific diagnosis like aphthous ulcer, might be classified using K13.7.
Documentation should include a description of the lesion's appearance, location, size, any associated symptoms, and the results of any diagnostic tests performed. Clinical findings and history leading to the use of this code should be clearly outlined.
** Excludes2: certain disorders of gingiva and edentulous alveolar ridge (K05-K06) cysts of oral region (K09.-) diseases of tongue (K14.-) stomatitis and related lesions (K12.-)
- Specialties:Dentistry, Oral Surgery, Otolaryngology
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital (if admission is required for diagnostic procedures or treatment)