Is ICD-10-CM code C04 billable?

No, C04 (Malignant neoplasm of floor of mouth) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code C04 belong to?

C04 belongs to Chapter 2 of the ICD-10-CM tabular list: C00–D49 (Neoplasms).

C04

Non-Billable

ChapterC00–D49

Rankcategory

Description

Malignant neoplasm of floor of mouth

About ICD-10-CM code C04

The ICD-10-CM tabular list places Malignant neoplasm of floor of mouth at code C04, inside C00-D49 Neoplasms, within Malignant neoplasms of lip, oral cavity and pharynx (C00-C14). You should not submit this code on claims since it lacks billing specificity, use a child code.

Use a more specific code (4 billable)

C04.0Malignant neoplasm of anterior floor of mouth C04.1Malignant neoplasm of lateral floor of mouth C04.8Malignant neoplasm of overlapping sites of floor of mouth C04.9Malignant neoplasm of floor of mouth, unspecified

Metadata & Insights

•Non-billable category (requires more specific sub-code).
•Chapter 2: Neoplasms (C00-D49).

Instructional Notes

Use Additional Code

code to identify:
alcohol abuse and dependence (F10.-)
history of tobacco dependence (Z87.891)
tobacco dependence (F17.-)
tobacco use (Z72.0)

Clinical Hierarchy

BillableHas subcodes

CH2Neoplasms (C00-D49)

C00-C14Malignant neoplasms of lip, oral cavity and pharynx (C00-C14)

C04Malignant neoplasm of floor of mouthNot billable

C04.0Malignant neoplasm of anterior floor of mouthBillable

C04.1Malignant neoplasm of lateral floor of mouthBillable

C04.8Malignant neoplasm of overlapping sites of floor of mouthBillable

C04.9Malignant neoplasm of floor of mouth, unspecifiedBillable

MS-DRG Classification

2026

No direct MS-DRG triggers identified.

Cross Reference

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