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C03

Non-Billable (Header)

Malignant neoplasm of gum

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

What This Code Means

C03 is the ICD-10-CM diagnosis code for malignant neoplasm of gum. C03 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of lip, oral cavity and pharynx (c00-c14).

Header codes like C03 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at C03's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for C03 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • malignant neoplasm of alveolar (ridge) mucosa
  • malignant neoplasm of gingiva

Excludes 2 — Not included here, may code separately

Use Additional Code

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

Child Codes

Code Hierarchy

C03Malignant neoplasm of gum
C03Malignant neoplasm of gum

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