ICDcodes.org
FY2027

C00.5 — Malignant neoplasm of lip, unspecified, inner aspect

BillableUnspecified

Is C00.5 billable?

Yes, but C00.5 is an unspecified code. C00.5 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, C00.5 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting C00.5 — the more specific alternatives are listed below.

C00.5 at a glance

CodeC00.5
DescriptionMalignant neoplasm of lip, unspecified, inner aspect
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

Which MS-DRGs does C00.5 group to?

C00.5 sits in MDC Pre and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 011Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCCsurgical
  • 012Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CCsurgical
  • 013Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCCsurgical

Inclusion terms

Alternative wording in documentation that is classified to C00.5.

  • Malignant neoplasm of buccal aspect of lip, unspecified
  • Malignant neoplasm of frenulum of lip, unspecified
  • Malignant neoplasm of mucosa of lip, unspecified
  • Malignant neoplasm of oral aspect of lip, unspecified

Excludes1 — never code together — inherited from C00

The conditions below can never be reported together with C00.5 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • malignant melanoma of lip (C43.0)
  • Merkel cell carcinoma of lip (C4A.0)
  • other and unspecified malignant neoplasm of skin of lip (C44.0-)

Use additional code — inherited from C00

Report an additional code alongside C00.5 to fully describe the condition. C00.5 is sequenced first.

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

How long has C00.5 existed?

C00.5 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

What other codes are in the C00 family? (8)