ICD-10 · PDGM grouping
K13 Other diseases of lip and oral mucosa
All 13 codes in the K13 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
13
Can lead a claim
12
Cannot lead a claim
1
What CMS assigns to K13
12 of the 13 codes group to MMTA - Other (8) and MMTA - Gastrointestinal tract and Genitourinary system (4); 1 is assigned no clinical group. None of the 13 is assigned a comorbidity subgroup. 12 of the 13 can lead a claim.
Every code in K13
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| K13.0 | Diseases of lips | Can lead a claim | J | None |
| K13.1 | Cheek and lip biting | Can lead a claim | A | None |
| K13.2 Leukoplakia and other disturbances of oral epithelium, including tongue | ||||
| K13.21 | Leukoplakia of oral mucosa, including tongue | Can lead a claim | J | None |
| K13.22 | Minimal keratinized residual ridge mucosa | Can lead a claim | A | None |
| K13.23 | Excessive keratinized residual ridge mucosa | Can lead a claim | A | None |
| K13.24 | Leukokeratosis nicotina palati | Can lead a claim | A | None |
| K13.29 | Other disturbances of oral epithelium, including tongue | Can lead a claim | J | None |
| K13.3 | Hairy leukoplakia | Can lead a claim | A | None |
| K13.4 | Granuloma and granuloma-like lesions of oral mucosa | Can lead a claim | A | None |
| K13.5 | Oral submucous fibrosis | Can lead a claim | A | None |
| K13.6 | Irritative hyperplasia of oral mucosa | Can lead a claim | A | None |
| K13.7 Other and unspecified lesions of oral mucosa | ||||
| K13.70 | Unspecified lesions of oral mucosa | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| K13.79 | Other lesions of oral mucosa | Can lead a claim | J | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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