ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 K13.0

Billable / Specific

Diseases of lips

K13
Block
11
Synonyms
28
LCDs
3
Payer Policies
4
Linked CPTs

About ICD-10-CM K13.0

ICD-10-CM code K13.0 represents Diseases of lips. This is a billable/specific code in the Digestive System chapter (block K13). The 2026 edition of ICD-10-CM K13.0 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under K13.0. Per CMS ICD-10-CM Tabular 2026.

  • Abscess of lips
  • Angular cheilitis
  • Cellulitis of lips
  • Cheilitis NOS
  • Cheilodynia
  • Cheilosis
  • Exfoliative cheilitis
  • Fistula of lips
  • Glandular cheilitis
  • Hypertrophy of lips
  • Perlèche NEC

Type 1 Excludes

Pure excludes, these codes can never be coded together with K13.0. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • ariboflavinosis (E53.0)
  • cheilitis due to radiation-related disorders (L55-L59)
  • congenital fistula of lips (Q38.0)
  • congenital hypertrophy of lips (Q18.6)
  • Perlèche due to candidiasis (B37.83)
  • Perlèche due to riboflavin deficiency (E53.0)

Medicare LCD Coverage for K13.0

Local Coverage Determinations (LCDs) from CMS MACs that list K13.0 as a covered diagnosis.

28 LCDs

Showing top 10 of 28 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92524 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 96112 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92521 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97130 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97129 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92597 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97110 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97533 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 96110 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92522 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing K13.0.

3 policies

1 Cigna

Head and Neck Ultrasound - (0549)
Policy ID: MM_0549

2 Medicare

Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Policy ID: ART-54111
Billing and Coding: Incision and Drainage (I&D) of Abscess of Skin, Subcutaneous and Accessory Structures
Policy ID: ART-56766

CPT Codes Commonly Billed with K13.0

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

4 linkages
  • 10081 CMS LCD: Billing and Coding: Incision and Drainage (I&D) of Abscess of Skin, Subcutaneous and Accessory Structures CMS LCD
  • 10180 CMS LCD: Billing and Coding: Incision and Drainage (I&D) of Abscess of Skin, Subcutaneous and Accessory Structures CMS LCD
  • 10080 CMS LCD: Billing and Coding: Incision and Drainage (I&D) of Abscess of Skin, Subcutaneous and Accessory Structures CMS LCD
  • 10160 CMS LCD: Billing and Coding: Incision and Drainage (I&D) of Abscess of Skin, Subcutaneous and Accessory Structures CMS LCD

Convert K13.0 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
K13.0 5285 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 K13.0, Billing FAQ

Is ICD-10 code K13.0 billable? +

Yes, K13.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to K13.0? +

ICD-10 K13.0 includes: Abscess of lips; Angular cheilitis; Cellulitis of lips, and 8 more clinical synonyms.

What codes are Type 1 Excludes for K13.0? +

Type 1 Excludes (never code together with K13.0): ariboflavinosis (E53.0); cheilitis due to radiation-related disorders (L55-L59); congenital fistula of lips (Q38.0)

What CPT codes are commonly billed with K13.0? +

Procedures frequently paired with K13.0 include: 10081, 10180, 10080, 10160.

What ICD-9 codes does K13.0 map to? +

Per CMS GEMs, K13.0 maps to ICD-9 codes: 5285. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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