Coding Stomatitis and Related Lesions in Dentistry

by | Published on Oct 8, 2021 | Podcasts, Dental Billing & Coding (P) | 0 comments

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Outsource Strategies International (OSI) provides dental billing services for small as well as large practices. We serve individual dentists, endodontists, orthodontists and periodontists. Our services cover everything from patient scheduling and insurance verification and authorization to billing, payment collections, and accounts receivable management.

In today’s podcast, Amber Darst, our Solutions Manager, discusses stomatitis and related oral lesions in dentistry.

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Hi, this is Amber Darst, Solutions Manager for Managed Outsourced Solutions and today I will be talking about understanding stomatitis and other related oral lesions in dentistry.

00:13 About stomatitis

Stomatitis is an oral condition referred to as an 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.

00:41 Types of stomatitis

So, the types of stomatitis include canker sores, cold sores, 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, chewing tobacco, oral inflammation and ulcers or any other type of mouth infection. Such sores can be caused by poor nutrition, stress, a mouth injury, a weaken 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 chelitis, which is inflammation of the lips and then around the mouth, glossitis which is inflammation of the tongue, gingivitis (inflammation of the gums) and then pharyngitis, which is inflammation of the back of the mouth.

01:53 Symptoms and treatment

Common symptoms include mouth ulcers red patches, swelling and lesions. Treatment options for these severe sores include Lidex gel, Aphthasol anti-inflammatory paste, Peridex mouthwash, and anti-inflammatory drugs such as corticosteroids. Billing for these types of oral conditions can be tricky. To submit error free medical claims, practices can consider partnering with an experienced dental billing service company. Our coders here at Manage Outsourced Solutions make sure to stay up to date with the changing coding standards.

For a full list of these codes associated with this podcast, please refer to the attached article.

  • 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)

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

And that’s all for now. Thanks for listening in.

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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