C06.9: Malignant neoplasm of mouth, unspecified
C06.9 is a billable, specific ICD-10-CM code for malignant neoplasm of mouth, unspecified. It is valid for submission on a claim.
Check C06.9 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Malignant neoplasm of minor salivary gland, unspecified site
- Malignant neoplasm of oral cavity NOS
Other codes that can never be billed with C06.9
Their own Excludes1 notes name this code, so the conflict is not listed above.
- C14Malignant neoplasm of other and ill-defined sites in the lip, oral cavity and pharynx
Risk adjustment
C06.9 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 21 Lymphoma and Other Cancers0.671 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
C06.9 is named in 45 Medicare coverage policies: 45 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52479Oral Anticancer Drugs - Policy Article
- A54768Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy
- A56462Billing and Coding: Erythropoiesis Stimulating Agents (ESA)
Code history
Unchanged in every release from FY2024 to FY2027.