C00.5

C00.5: Malignant neoplasm of lip, unspecified, inner aspect

Billable / specific codeICD-10-CM

C00.5 is a billable, specific ICD-10-CM code for malignant neoplasm of lip, unspecified, inner aspect. It is valid for submission on a claim.

Check C00.5 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Malignant neoplasm of buccal aspect of lip, unspecified
Malignant neoplasm of frenulum of lip, unspecified
Malignant neoplasm of mucosa of lip, unspecified
Malignant neoplasm of oral aspect of lip, unspecified

Excludes1 inherited from the categories above C00.5

A category’s note binds every code beneath it.

Written on C00: Malignant neoplasm of lip

malignant melanoma of lip (C43.0)
Merkel cell carcinoma of lip (C4A.0)
other and unspecified malignant neoplasm of skin of lip (C44.0-)

Other codes that can never be billed with C00.5

Their own Excludes1 notes name this code, so the conflict is not listed above.

C44.0Other and unspecified malignant neoplasm of skin of lip

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

C00.5 is named in 49 Medicare coverage policies: 49 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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A52479Oral Anticancer Drugs - Policy Article
A56462Billing and Coding: Erythropoiesis Stimulating Agents (ESA)
A56514Billing and Coding: Mohs Micrographic Surgery

Code history

Unchanged in every release from FY2024 to FY2027.