K12.1

K12.1: Other forms of stomatitis

Billable / specific codeICD-10-CM

K12.1 is a billable, specific ICD-10-CM code for other forms of stomatitis. It is valid for submission on a claim.

Check K12.1 with the rest of the claim: free scrubber

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

acute necrotizing ulcerative stomatitis (A69.1)
Vincent's stomatitis (A69.1)

Inclusion terms

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

Stomatitis NOS
Denture stomatitis
Ulcerative stomatitis
Vesicular stomatitis

Excludes1 inherited from the categories above K12.1

A category’s note binds every code beneath it.

Written on K12: Stomatitis and related lesions

cancrum oris (A69.0)
cheilitis (K13.0)
gangrenous stomatitis (A69.0)
herpesviral [herpes simplex] gingivostomatitis (B00.2)
noma (A69.0)

Risk adjustment

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

Medicare coverage

K12.1 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders

Alphabetic index entries that lead here

Stomatitis(denture) (ulcerative)
Catarrh, catarrhal›mouth
Inflammation, inflamed, inflammatory›mouth
Stomatitis›catarrhal
Stomatitis›follicular
Stomatitis›malignant
Stomatitis›membranous acute
Stomatitis›septic
Stomatitis›vesicular
Ulcer, ulcerated, ulcerating, ulceration, ulcerative›buccal(cavity) (traumatic)
Ulcer, ulcerated, ulcerating, ulceration, ulcerative›oral mucosa(traumatic)
Ulcer, ulcerated, ulcerating, ulceration, ulcerative›palate(soft)

Code history

Unchanged in every release from FY2024 to FY2027.