C03.1
BillableMalignant neoplasm of lower gum
HCC Category Mapping
V28HCC 21 — Breast, Prostate, Colorectal and Other Cancers and Tumors
0.545V24HCC 11 — Colorectal, Bladder, and Other Cancers
0.306ESRDHCC 11 — Colorectal, Bladder, and Other Cancers
0.000RxHCCHCC 22 — Cancer, Other Specified Sites
0.000What This Code Means
Cancer that starts in the lower gum tissue, typically involving the tissue covering the lower jaw bone.
Coding Tips
Clinical Significance
Malignant neoplasm of the lower gum involves cancer of the mandibular gingiva. Lower gum cancers are more common than upper gum cancers and frequently invade the mandibular bone, often requiring more extensive surgical intervention including mandibulectomy.
Documentation Requirements
- ✓Pathology-confirmed malignancy with histological type (typically squamous cell carcinoma)
- ✓Specific site documented as lower gum or mandibular gingiva
- ✓TNM staging with depth of invasion, particularly bone involvement
- ✓Laterality if documented (left vs right mandibular gingiva)
- ✓Treatment plan and current status (active, remission, or surveillance)
Commonly Confused Codes
C03.0 — Malignant neoplasm of upper gum; ensure documentation specifies mandibular (lower) not maxillary (upper) gingivaC03.9 — Malignant neoplasm of gum, unspecified; avoid when lower gum is clearly documentedC41.1 — Malignant neoplasm of mandible; use when cancer originates in bone rather than overlying gum tissueC04.0 — Malignant neoplasm of anterior floor of mouth; adjacent site that may overlap with lower gum tumors
Code Hierarchy
└C03Malignant neoplasm of gum└C03.1Malignant neoplasm of lower gum
└C03.1Malignant neoplasm of lower gum