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.
Inclusion 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
These codes carry an Excludes1 note pointing at C06.9. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C06.9 alone.
- 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.
Medicare coverage
C06.9 is named in 45 Medicare coverage policies — 45 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
- A52479Oral Anticancer Drugs - Policy Article
Related codes at this level
Codes that share C06. If C06.9 is not quite right, the correct code is usually one of these.
Questions about C06.9
- Is C06.9 a billable ICD-10-CM code?
- Yes. C06.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C06.9 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of lip, oral cavity and pharynx (C00-C14).