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Medical coding for oral mucositis

ICD-10 codes from mucositis

Mucositis is the painful inflammation and ulceration of the mucous membranes lining the digestive tract, usually as an adverse effect of chemotherapy and radiotherapy treatment for cancer.

Diagnosis coding options:

K12.0 - Recurrent oral aphthae

K12.1 - Other forms of stomatitis

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

K12.32 - Oral mucositis (ulcerative) due to other drugs

K12.33 - Oral mucositis (ulcerative) due to radiation

K12.39 - Other oral mucositis (ulcerative)

T45.1X5 - Adverse effect, if applicable, to identify antineoplastic and immunosuppressive drugs

CPT/HCPCS coding 

S8948  - Application of a modality (requiring constant provider attendance) to one or more areas; low-level laser; each 15 minutes.

41820 - Destruction of lesion, vestibule of mouth by physical methods

41850 - Destruction of lesion; dentoalveolar structures

42160 - Destruction of lesion, palate or uvula

Sample medical coverage policy from BCBS Florida titled "Infrared Energy Therapy and Low Level Laser Therapy which states “Low-level laser therapy meets the definition of medical necessity for prevention of oral mucositis in members undergoing cancer treatment associated with increased risk of oral mucositis, including chemotherapy and/or radiotherapy, and/or hematopoietic stem cell transplantation.”