ICD-10-CM Code For Malignant Neoplasm Of Gum: Group Overview

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group C03 includes malignant neoplasms of the gingiva, covering cancers originating in the gum tissue and potentially extending to adjacent oral structures such as the alveolar mucosa or nearby oral mucosa. These ICD-10-CM diagnosis codes are used to document primary gum cancers and related clinical details, capturing lesion location, laterality when specified, and any extension to surrounding tissues. Accurate coding within the ICD-10-CM C03 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

Customize your policy alerts

Sign up for ICD-10-CM Code For Malignant Neoplasm Of Gum: Group Overview policy alerts

Get alerted when relevant policies change without checking for updates manually.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

ICD-10-CM C03: Malignant Neoplasm Of Gum Overview

This group represents malignant tumors originating in the gingival tissues of the oral cavity and is part of the broader malignant neoplasms of lip, oral cavity and pharynx category. It targets cancers localized to the gums which may involve adjacent oral structures. Accurate coding is important for precise clinical records and supports correct reimbursement and care coordination.

When to Use

Use a code from this group when a primary malignancy is documented as arising in the gingiva or gum tissue of the oral cavity. Select the most specific code available to reflect laterality, exact site, and any documented extension to adjacent oral structures.

ICD-10-CM Codes

3 rows

ICD-10-CM Code	Description
C03.0	Malignant neoplasm of upper gum
C03.1	Malignant neoplasm of lower gum
C03.9	Malignant neoplasm of gum, unspecified

DRG Codes

6 rows

DRG Code	Description
011	Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCC
012	Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CC
013	Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCC
146	Ear, Nose, Mouth and Throat Malignancy with MCC
147	Ear, Nose, Mouth and Throat Malignancy with CC
148	Ear, Nose, Mouth and Throat Malignancy without CC/MCC

Typical Clinical Scenarios

An older adult with a long history of tobacco and heavy alcohol use presents with a persistent, non-healing ulcerative lesion on the gingiva that bleeds with minimal trauma and has associated ipsilateral cervical lymphadenopathy. The patient is referred from primary care to ENT/oral surgery for biopsy and staging; a pathology report confirms an invasive squamous cell carcinoma of the gum, prompting assignment of a malignant gum neoplasm code. Typical codes: C03.0, C03.9
A middle-aged patient returns for ongoing management months after partial mandibulectomy for a previously diagnosed gum cancer, now undergoing surveillance and consideration of adjuvant therapy due to close margins on surgical pathology. Because the encounter documents the site-specific malignant neoplasm of the gum as active disease requiring continued oncology care, a code for malignant neoplasm of gum is reported to reflect the primary site under treatment. Typical codes: C03.1, C03.9
An emergency department visit for acute jaw pain and rapidly progressive swelling over the posterior gingiva in a patient with known metastatic disease; imaging shows local tumor extension into adjacent oral soft tissues with secondary infection. The clinician documents an acute complication related to the primary malignant neoplasm of the gum to guide urgent management and coordination with oncology and maxillofacial surgery. Typical codes: C03.0, C03.1

Related Codes

C00-MALIGNANT-NEOPLASM-OF-LIP

ICD-10-CM Code For Malignant Neoplasm Of Lip: Group Overview

C01-MALIGNANT-NEOPLASM-BASE-OF-TONGUE

ICD-10-CM Code For Malignant Neoplasm Of Base Of Tongue: Group Overview

C02-MALIGNANT-NEOPLASM-OF-TONGUE

ICD-10-CM Code For Malignant Neoplasm Of Other And Unspecified Parts Of Tongue: Group Overview

C04-MALIGNANT-NEOPLASM-OF-FLOOR-OF-MOUTH

ICD-10-CM Code For Malignant Neoplasm Of Floor Of Mouth: Group Overview

C05-MALIGNANT-NEOPLASM-OF-PALATE

ICD-10-CM Code For Malignant Neoplasm Of Palate: Group Overview

C06-MALIGNANT-NEOPLASM-OF-MOUTH

ICD-10-CM Code For Malignant Neoplasm Of Other And Unspecified Parts Of Mouth: Group Overview

C07-MALIGNANT-NEOPLASM-OF-PAROTID-GLAND

ICD-10-CM Code For Malignant Neoplasm Of Parotid Gland: Group Overview

C08-MALIGNANT-SALIVARY-GLAND-NEOPLASMS

ICD-10-CM Code For Malignant Neoplasm Of Other And Unspecified Major Salivary Glands: Group Overview

C09-MALIGNANT-NEOPLASM-OF-TONSIL

ICD-10-CM Code For Malignant Neoplasm Of Tonsil: Group Overview

C10-MALIGNANT-NEOPLASM-OF-OROPHARYNX

ICD-10-CM Code For Malignant Neoplasm Of Oropharynx: Group Overview

Showing 1–10 of 14

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Explore openpayer tools

View all tools

When to Use

ICD-10-CM Codes

3 rows

ICD-10-CM Code	Description
C03.0	Malignant neoplasm of upper gum
C03.1	Malignant neoplasm of lower gum
C03.9	Malignant neoplasm of gum, unspecified

DRG Codes

6 rows

DRG Code	Description
011	Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCC
012	Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CC
013	Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCC
146	Ear, Nose, Mouth and Throat Malignancy with MCC
147	Ear, Nose, Mouth and Throat Malignancy with CC
148	Ear, Nose, Mouth and Throat Malignancy without CC/MCC

Typical Clinical Scenarios

An older adult with a long history of tobacco and heavy alcohol use presents with a persistent, non-healing ulcerative lesion on the gingiva that bleeds with minimal trauma and has associated ipsilateral cervical lymphadenopathy. The patient is referred from primary care to ENT/oral surgery for biopsy and staging; a pathology report confirms an invasive squamous cell carcinoma of the gum, prompting assignment of a malignant gum neoplasm code. Typical codes: C03.0, C03.9
A middle-aged patient returns for ongoing management months after partial mandibulectomy for a previously diagnosed gum cancer, now undergoing surveillance and consideration of adjuvant therapy due to close margins on surgical pathology. Because the encounter documents the site-specific malignant neoplasm of the gum as active disease requiring continued oncology care, a code for malignant neoplasm of gum is reported to reflect the primary site under treatment. Typical codes: C03.1, C03.9
An emergency department visit for acute jaw pain and rapidly progressive swelling over the posterior gingiva in a patient with known metastatic disease; imaging shows local tumor extension into adjacent oral soft tissues with secondary infection. The clinician documents an acute complication related to the primary malignant neoplasm of the gum to guide urgent management and coordination with oncology and maxillofacial surgery. Typical codes: C03.0, C03.1

Related Codes

C00-MALIGNANT-NEOPLASM-OF-LIP

ICD-10-CM Code For Malignant Neoplasm Of Lip: Group Overview

C01-MALIGNANT-NEOPLASM-BASE-OF-TONGUE

ICD-10-CM Code For Malignant Neoplasm Of Base Of Tongue: Group Overview

C02-MALIGNANT-NEOPLASM-OF-TONGUE

ICD-10-CM Code For Malignant Neoplasm Of Other And Unspecified Parts Of Tongue: Group Overview

C04-MALIGNANT-NEOPLASM-OF-FLOOR-OF-MOUTH

ICD-10-CM Code For Malignant Neoplasm Of Floor Of Mouth: Group Overview

C05-MALIGNANT-NEOPLASM-OF-PALATE

ICD-10-CM Code For Malignant Neoplasm Of Palate: Group Overview

C06-MALIGNANT-NEOPLASM-OF-MOUTH

ICD-10-CM Code For Malignant Neoplasm Of Other And Unspecified Parts Of Mouth: Group Overview

C07-MALIGNANT-NEOPLASM-OF-PAROTID-GLAND

ICD-10-CM Code For Malignant Neoplasm Of Parotid Gland: Group Overview

C08-MALIGNANT-SALIVARY-GLAND-NEOPLASMS

ICD-10-CM Code For Malignant Neoplasm Of Other And Unspecified Major Salivary Glands: Group Overview

C09-MALIGNANT-NEOPLASM-OF-TONSIL

ICD-10-CM Code For Malignant Neoplasm Of Tonsil: Group Overview

C10-MALIGNANT-NEOPLASM-OF-OROPHARYNX

ICD-10-CM Code For Malignant Neoplasm Of Oropharynx: Group Overview

Showing 1–10 of 14

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

ICD-10-CM Code For Malignant Neoplasm Of Gum: Group Overview

Sign up for ICD-10-CM Code For Malignant Neoplasm Of Gum: Group Overview policy alerts

ICD-10-CM C03: Malignant Neoplasm Of Gum Overview

ICD-10-CM Code For Malignant Neoplasm Of Gum: Group Overview

Sign up for ICD-10-CM Code For Malignant Neoplasm Of Gum: Group Overview policy alerts

ICD-10-CM C03: Malignant Neoplasm Of Gum Overview

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

What clinical conditions are included in ICD-10-CM code group `C03`?

Which specific ICD-10-CM codes comprise the `C03` group?

Why is accurate coding within `C03` important for billing and reimbursement?

How does `C03` relate to DRG groupings used for inpatient reimbursement?

What documentation elements should be captured to select the correct `C03` code?

References

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

What clinical conditions are included in ICD-10-CM code group `C03`?

Which specific ICD-10-CM codes comprise the `C03` group?

Why is accurate coding within `C03` important for billing and reimbursement?

How does `C03` relate to DRG groupings used for inpatient reimbursement?

What documentation elements should be captured to select the correct `C03` code?

References