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K12 ICD-10-CM Code: Stomatitis and related lesions

K12 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupK12

FY 2026 Apr update / Diseases of the digestive system (K00-K95) / Diseases of oral cavity and salivary glands (K00-K14)

K12

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Stomatitis and related lesions

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

N/A

—

Not mapped

CMS-HCC V24

N/A

—

Not mapped

ACA/HHS

N/A

—

Not mapped

ESRD/PACE

N/A

—

Not mapped

RXHCC

N/A

—

Not mapped

Code Book Path

Official
K1Diseases of oral cavity and salivary glands (K00-K14)K12Stomatitis and related lesions

Inclusion Terms

Official

No inclusion terms are included in this display for K12. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • certain conditions originating in the perinatal period (P04-P96)Inherited from K00-K95
  • certain infectious and parasitic diseases (A00-B99)Inherited from K00-K95
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from K00-K95
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from K00-K95
  • endocrine, nutritional and metabolic diseases (E00-E88)Inherited from K00-K95
  • injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from K00-K95
  • neoplasms (C00-D49)Inherited from K00-K95
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from K00-K95

Related Codes

Official
K12.0Recurrent oral aphthaeK12.1Other forms of stomatitisK12.2Cellulitis and abscess of mouthK12.3Oral mucositis (ulcerative)

Includes

Official

No Includes notes are included in this display for K12. Check the code and parent instructions in the Code Book.

Excludes 1

Official
  • cancrum oris (A69.0)
  • cheilitis (K13.0)
  • gangrenous stomatitis (A69.0)
  • herpesviral [herpes simplex] gingivostomatitis (B00.2)
  • noma (A69.0)

Code First

Official

No Code First sequencing instructions are included in this display for K12. Check the code and parent instructions in the Code Book.

Use Additional

Official
  • code to identify:
  • alcohol abuse and dependence (F10.-)
  • exposure to environmental tobacco smoke (Z77.22)
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Code Also

Official

No Code Also instructions are included in this display for K12. Check the code and parent instructions in the Code Book.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
K12
Description
Stomatitis and related lesions
HCC (V28)
No CMS-HCC V28 mapping
RAF reference coefficient
—
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

K12 is the ICD-10-CM diagnosis code for stomatitis and related lesions. K12 sits in the ICD-10-CM chapter for diseases of the digestive system (k00-k95), within the section covering diseases of oral cavity and salivary glands (k00-k14).

Header codes like K12 cannot be reported on claims directly; they organize child codes that share clinical context. Coders should select the billable child code that matches the documented presentation and then verify its current source-backed HCC mapping. Do not infer a child code or risk adjustment value from the header alone.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for K12 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • cancrum oris (A69.0)
  • cheilitis (K13.0)
  • gangrenous stomatitis (A69.0)
  • herpesviral [herpes simplex] gingivostomatitis (B00.2)
  • noma (A69.0)

Use Additional Code

  • code to identify:
  • alcohol abuse and dependence (F10.-)
  • exposure to environmental tobacco smoke (Z77.22)
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Child Codes

K12.0Recurrent oral aphthae
K12.1Other forms of stomatitis
K12.2Cellulitis and abscess of mouth
K12.3Oral mucositis (ulcerative)

Code Hierarchy

└K12Stomatitis and related lesions
└K12Stomatitis and related lesions

Work K12 in HCC Buddy

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