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Stomatitis is an oral condition referred to as inflamed and sore mouth. This is a type of mucositis, caused by inflammation of the mucous membrane. It can disrupt one’s ability to eat, talk, and sleep. It can occur anywhere in the mouth, including the inside of the cheeks, gums, tongue, lips, and palate. The treatment often focuses on managing the symptoms. Dentists treating this condition can rely on professional dental billing companies to get the dental claims submitted with the right diagnosis and procedure codes.

ICD-10 Codes to Report Stomatitis and Related Lesions

  • K12 Stomatitis and related lesions
    • K12.0 Recurrent oral aphthae
    • K12.1 Other forms of stomatitis
    • K12.2 Cellulitis and abscess of mouth
    • K12.3 Oral mucositis (ulcerative)
      • K12.30 …… unspecified
      • K12.31 …… due to antineoplastic therapy
      • K12.32 …… due to other drugs
      • K12.33 …… due to radiation
      • K12.39 Other oral mucositis (ulcerative)

Additional codes can be used to identify:

Alcohol Abuse and Dependence

  • F10 Alcohol related disorders
    • F10.1 Alcohol abuse
    • F10.2 Alcohol dependence
    • F10.9 Alcohol use, unspecified

Exposure to Environmental Tobacco Smoke

  • Z77.22 Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic)

Exposure to Tobacco Smoke in the Perinatal Period

  • P96.81 Exposure to (parental) (environmental) tobacco smoke in the perinatal period

History of Tobacco Dependence

  • Z87.891 Personal history of nicotine dependence

Occupational Exposure to Environmental Tobacco Smoke

  • Z57.31 Occupational exposure to environmental tobacco smoke

Stomatitis coding excludes

Cancrum oris, noma and gangrenous stomatitis

  • A69.0 Necrotizing ulcerative stomatitis


  • K13.0 Diseases of lips

Herpesviral [herpes simplex] gingivostomatitis

  • B00.2 Herpesviral gingivostomatitis and pharyngotonsillitis

The types of stomatitis include canker sore or aphthous ulcer, cold sores or fever blisters and mouth irritation. While canker sores appear as ulcers in the mouth, usually on the cheeks, tongue, or inside the lip, cold sores appear as fluid-filled sores on or around the lips. At the same time, mouth irritation can be caused due to gum disease (gingivitis), chewing tobacco, oral inflammation and ulcers or any other type of mouth infection. Such sores can be caused by poor nutrition, stress, mouth injury, a weak immune system, lack of sleep, hormonal changes, or side effects of chemotherapy and sometimes radiotherapy. Depending on the area of the mouth affected, stomatitis can be broken down into different categories such as – cheilitis (inflammation of the lips and around the mouth), glossitis (inflammation of the tongue), gingivitis (inflammation of the gums) and pharyngitis (inflammation of the back of the mouth).

Common symptoms include mouth ulcers, red patches, swelling, lesions that heal in 4 days – two weeks. Treatment options for severe sores include Lidex gel, Aphthasol anti-inflammatory paste, Peridex mouthwash, and anti-inflammatory drugs like corticosteroids. To submit error-free medical claims, practices can consider partnering with an experienced dental billing service. Make sure that the coders are up to date with the changing coding standards.

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Amber Darst

Amber Darst is our Solutions Manager in the Healthcare Division, Practice and RCM. With a rich background in dental services, her expertise ranges from insurance coordination to office management.

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