K11.5 — Sialolithiasis
K11.5 is a billable, specific ICD-10-CM code for sialolithiasis. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Calculus of salivary gland or duct
- Stone of salivary gland or duct
Risk adjustment
K11.5 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
K11.5 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
How K11.5 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to K11.5.
- Ptyalolithiasis
- Sialodocholithiasis
- Sialolithiasis
- Calculus, calculi, calculous›parotid duct or gland
- Calculus, calculi, calculous›salivary(duct) (gland)
- Calculus, calculi, calculous›Stensen's duct
- Calculus, calculi, calculous›sublingual duct or gland
- Calculus, calculi, calculous›submandibular duct, gland or region
- Calculus, calculi, calculous›submaxillary duct, gland or region
- Calculus, calculi, calculous›Wharton's duct
- Concretion›salivary gland(any)
- Stone›salivary gland or duct(any)
Related codes at this level
Codes that share K11. If K11.5 is not quite right, the correct code is usually one of these.
Questions about K11.5
- Is K11.5 a billable ICD-10-CM code?
- Yes. K11.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K11.5 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Diseases of oral cavity and salivary glands (K00-K14).