K13.5

Oral submucous fibrosis

FY2027Chapter 11: Diseases of the digestive system/K00–K14 Diseases of oral cavity and salivary glands

BillableComplete code, valid to report

K13.5 (also written K135) is a billable ICD-10-CM diagnosis code for oral submucous fibrosis. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 13 codes in category K13 (Other diseases of lip and oral mucosa). The Alphabetic Index lists it under 2 entries. Its coding notes include a Use additional code instruction and 12 Excludes2 entries.

Use additional code

Add the listed code as a secondary code, if known.

Inherited from K13 Other diseases of lip and oral mucosa
  • 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)

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Inherited from K13 Other diseases of lip and oral mucosa
  • certain disorders of gingiva and edentulous alveolar ridge (K05-K06)
  • cysts of oral region (K09.-)
  • diseases of tongue (K14.-)
  • stomatitis and related lesions (K12.-)
Also from chapter/block level (8 notes)
Inherited from Chapter 11 Diseases of the digestive system
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the MMTA - Other clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

Includes

Further defines or gives examples of the content of the category.

Inherited from K13 Other diseases of lip and oral mucosa
  • epithelial disturbances of tongue

Inclusion terms

Conditions classified to this code.

This code
  • Submucous fibrosis of tongue

Alphabetic Index terms

Terms the official Alphabetic Index lists for this code. 2 entries