K12.31

K12.31: Oral mucositis (ulcerative) due to antineoplastic therapy

Billable / specific codeICD-10-CM

K12.31 is a billable, specific ICD-10-CM code for oral mucositis (ulcerative) due to antineoplastic therapy. It is valid for submission on a claim.

Check K12.31 with the rest of the claim: free scrubber

Use additional code

Add a secondary code to capture the detail described below.

code for adverse effect, if applicable, to identify antineoplastic and immunosuppressive drugs (T45.1X5)
code for other antineoplastic therapy, such as:
radiological procedure and radiotherapy (Y84.2)

Excludes1 inherited from the categories above K12.31

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)

Excludes2 inherited from the categories above K12.31

Not part of this code, but both may be coded when both are present.

Written on K12.3: Oral mucositis (ulcerative)

gastrointestinal mucositis (ulcerative) (K92.81)
mucositis (ulcerative) of vagina and vulva (N76.81)
nasal mucositis (ulcerative) (J34.81)

Risk adjustment

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

Medicare coverage

K12.31 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