C06.1 Malignant neoplasm of vestibule of mouth

Billable ICD-10-CM code, FY2026.

Applicable to

• Malignant neoplasm of buccal sulcus (upper) (lower)
• Malignant neoplasm of labial sulcus (upper) (lower)

Applies from C06 Malignant neoplasm of other and unspecified parts of mouth

Use additional code

• code to identify:
• alcohol abuse and dependence (F10.-)
• history of tobacco dependence (Z87.891)
• tobacco dependence (F17.-)
• tobacco use (Z72.0)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 21 — Lymphoma and Other Cancers
• CMS-HCC V22: HCC 11 — Colorectal, Bladder, and Other Cancers
• RxHCC V08: HCC 22 — Prostate, Breast, Bladder, and Other Cancers and Tumors
• ESRD V24: HCC 11

MS-DRG index

Defines the logic of DRG(s) 011-013 in MDC PRE.

Approximate ICD-9-CM (GEMs)

• 145.1 Malignant neoplasm of vestibule of mouth

Nearby codes

• C06 Malignant neoplasm of other and unspecified parts of mouth
• C06.0 Malignant neoplasm of cheek mucosa
• C06.1 Malignant neoplasm of vestibule of mouth (this code)
• C06.2 Malignant neoplasm of retromolar area
• C06.8 Malignant neoplasm of overlapping sites of other and unspecified parts of mouth
• C06.80 Malignant neoplasm of overlapping sites of unspecified parts of mouth
• C06.89 Malignant neoplasm of overlapping sites of other parts of mouth
• C06.9 Malignant neoplasm of mouth, unspecified