April is observed as “Oral Cancer Awareness Month” in the United States. Sponsored by the Oral Cancer Foundation, the campaign acts as a unique platform to highlight the importance of early detection of oral cancer and encourage regular and timely screenings. It aims to alert people about the causes, symptoms and remove the stigma surrounding oral cancer. Oral or mouth cancer is a type of cancer that develops in the tissues of the mouth (known as the oral cavity) or the throat area at the back of the mouth (known as the oropharynx). Regarded as a type of head and neck cancer, these cancers come under the category of oral and oropharyngeal cancer that starts in the cells that line the mouth and throat (classified as squamous cell carcinoma). Over 90 percent of oral cancers begin in the flat cells (squamous cells) that cover the surfaces of the mouth, tongue, and lips. Early diagnosis of this type of cancer is often difficult, as patients show no specific signs and symptoms. If diagnosed in the early stages of development, the survival rate of this condition is about 80-90 percent. Billing and coding for this oral condition can be challenging, as there are several rules that go along with this condition. For precise documentation of this condition, physicians usually rely on the services of a professional medical billing outsourcing company.
Every hour, 24-hours-a-day, 365-days-a-year, someone dies of oral or oropharyngeal cancer (cancer of the mouth and upper throat). According to reports from the American Cancer Society (ACS), around 53,000 new cases of oral cancer will be diagnosed in 2020. This includes those cancers that occur in the mouth itself, (salivary gland cancers, tongue cancers, mucosal soft tissue cancers), in the very back of the mouth known as the oropharynx, (primarily tonsil and tonsillar crypt and base of tongue), and on the exterior lips of the mouth. The condition is more likely to affect males than females. Of those individuals, 43 percent will not survive longer than five years, and many who do survive suffer long-term problems, such as severe facial disfigurement or difficulties with eating and speaking. The average age of diagnosis is 62 years, but about 25 percent of cases occur before the age of 55 years.
Oral cancers occur when cells on the lips or in the mouth develop changes (mutations) in their DNA and starts growing without control. As these continue to grow and accumulate, they form a tumor. With time, they may spread inside the mouth and migrate to other areas of the head and neck or other parts of the body. There are two distinct pathways by which most people get oral and oropharyngeal cancer. One is through the use of tobacco and alcohol, a long-term historic problem and cause, and the other is through exposure to the HPV-16 virus (human papilloma virus version 16). A small percentage of people (under about 10%) get oral cancers from no currently identified cause.
As tobacco and alcohol use are serious risk factors associated with the condition, smokers and heavy drinkers need to undergo regular dental checkups to spot any symptoms at an early stage. Common symptoms include – mouth sores or ulcers (that bleed easily and do not heal), red or white patches in or behind the mouth, visible change in mouth tissue, unexplained swelling or fullness in neck, loose teeth, difficult or painful swallowing, and pain and tenderness in the teeth or gums. The type and severity of symptoms may depend and vary from person to person. For this reason, correct and early diagnosis of symptoms and appropriate treatment administration is important for effectively combating oral cancer.
Diagnosis of oral cancer will begin with a detailed examination of the lips and mouth of the patient to check for abnormalities like – areas of irritation, such as sores and white patches (leukoplakia). If any suspicious area is diagnosed, the dentist may remove a sample of cells for lab testing. The sample cells are analyzed for cancer or precancerous changes that indicate a risk of future cancer. Once the mouth cancer is diagnosed or confirmed, the physician will further work to determine the extent or stage of cancer. Endoscopy procedure may be performed to look for signs whether the cancer has spread beyond the mouth area. In addition, a variety of imaging tests like X-ray, CT scan, MRI and positron emission tomography (PET) scans may be performed to determine the stage and severity of cancer. However, not every patient may need these tests. Physicians will determine which of these tests are appropriate based on individual patient condition.
Dentists, oncologists and other specialists have to report the diagnosis, screening tests and other procedures performed using the correct medical codes. Medical billing services offered by experienced medical billing and coding companies ensure this so that accurate claim submissions are done. In ICD-10, codes for oral cancer come under the category – C00-C14 – Malignant neoplasms of lip, oral cavity and pharynx. Under each specific category, there are several sub-category codes.
- C00 Malignant neoplasm of lip
- C01 Malignant neoplasm of base of tongue
- C02 Malignant neoplasm of other and unspecified parts of tongue
- C03 Malignant neoplasm of gum
- C04 Malignant neoplasm of floor of mouth
- C05 Malignant neoplasm of palate
- C06 Malignant neoplasm of other and unspecified parts of mouth
- C07 Malignant neoplasm of parotid gland
- C08 Malignant neoplasm of other and unspecified major salivary glands
- C09 Malignant neoplasm of tonsil
- C10 Malignant neoplasm of oropharynx
- C11 Malignant neoplasm of nasopharynx
- C12 Malignant neoplasm of pyriform sinus
- C13 Malignant neoplasm of hypopharynx
- C14 Malignant neoplasm of other and ill-defined sites in the lip, oral cavity and pharynx
Each April, several of the nation’s top dental associations join together with the Oral Cancer Foundation to raise awareness for oral and oropharyngeal cancers. As careful oral examination is the first step in prevention, many dental professionals around the country open their offices to do free screenings for the public during this month each year. This is an important reminder to the public that when these cancers are detected and treated early, mortality and treatment related health problems are reduced.
As part of the month-long observance, the Oral Cancer Foundation along with other dental associations introduced a new campaign “Check Your Mouth” initiative to encourage the public to regularly check for signs and symptoms of oral cancer between dental visits and to go for a detailed checkup with a dental professional if these symptoms do not improve or disappear after two or three weeks.
The goal of this annual initiative is to encourage adults to take advantage of the nationwide and international free screenings. Free screenings occur all over the United States and abroad any time during the year. However, in the month of April, there is a pinnacle week, named the Oral, Head and Neck Cancer Awareness Week® which promotes a high volume of free screenings all over the world, plus educational talks and other awareness programs.
Participate in the observance of “Oral Cancer Awareness Month” this April. Use this awareness platform to gain more information about oral cancer – its symptoms, causes and treatment options.