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2025 ICD-10-CM code C00.1

Malignant neoplasm of the external lower lip.

Use additional codes to document any related conditions, such as alcohol or tobacco dependence (F10.-, Z87.891, F17.-, Z72.0), or functional activity associated with the neoplasm (Chapter 4 codes). Do not use C00.1 with codes for malignant melanoma of the lip (C43.0), Merkel cell carcinoma of the lip (C4A.0), or other skin malignancies of the lip (C44.0-).

Medical necessity is established by the presence of a confirmed malignant neoplasm of the external lower lip, impacting the patient's health and requiring medical intervention. The specific treatment chosen should be supported by clinical findings, staging information, and the patient's overall condition.

Physicians diagnose this condition through patient history, physical examination of the mouth, and biopsy of the lesion. Further investigations like endoscopy and imaging studies may be necessary to assess for metastasis or other cancers. Treatment options include excision, Mohs surgery, radiation therapy, chemotherapy, or more extensive surgery depending on the stage and type of cancer.

In simple words: Cancer of the outer part of the lower lip.

This code signifies a cancerous growth located on the outer portion of the lower lip, specifically the vermilion border (the exposed red part). It often represents squamous cell carcinoma, the most prevalent type of oral cavity cancer. Key risk factors include excessive sun exposure and tobacco use.

Example 1: A 65-year-old male presents with a persistent ulcer on his lower lip, with a history of long-term sun exposure and tobacco use. Biopsy confirms squamous cell carcinoma, and the diagnosis is coded as C00.1., A 50-year-old female, with no significant risk factors, is diagnosed with a small, early-stage malignant lesion on her external lower lip, confirmed by biopsy. This is coded as C00.1., A 70-year-old male with a history of lip cancer treated 5 years prior now presents with numbness in his lower jaw and difficulty swallowing. Further examination reveals a recurrence of the malignancy on his external lower lip, again coded as C00.1. Additional codes may be used to indicate the recurrence and associated symptoms.

Documentation should include details of the lesion's location, size, appearance, biopsy results, and any associated symptoms such as pain, ulceration, bleeding, or numbness. Information about risk factors (sun exposure, tobacco use) and details of diagnostic procedures (endoscopy, imaging studies) should also be recorded.

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