K06.1 ICD-10-CM Code: Gingival enlargement
Compare with another code for K06.1Check this code on a claim
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- Official instructions
- 1 inclusion term · 4 Excludes2
Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.
What you need to know
Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.
- Excludes2from K06Not included here; may be reported together
- IncludesWhat this code covers
- Gingival fibromatosis
Where it sits Source: CMS/NCHS
Under:Chapter 11: Diseases of the Digestive SystemK00-K14 Diseases of oral cavity and salivary glandsK06 Other disorders of gingiva and edentulous alveolar ridge
Most relevant related codes MedCoder-derived
Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.
Inpatient Payment Groups (MS-DRG)
Potential MS-DRG participation — not a DRG assignment.
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.
- MS-DRG 011 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC (MDC PRE)
- MS-DRG 012 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC (MDC PRE)
- MS-DRG 013 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC (MDC PRE)
- MS-DRG 157 — DENTAL AND ORAL DISEASES WITH MCC (MDC 03)
- MS-DRG 158 — DENTAL AND ORAL DISEASES WITH CC (MDC 03)
- MS-DRG 159 — DENTAL AND ORAL DISEASES WITHOUT CC/MCC (MDC 03)
A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for K06.1 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026
Trace:FY2027 changesChange historyRelease, file and checksum
Notes without a marker are published on K06.1 itself; “inherited from” names the category or block whose note applies here.
Inclusion Terms
Alternative terms the tabular list files under this code.
- Gingival fibromatosis
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- acute gingivitis (K05.0) Compare K06.1 vs K05.0 →
- atrophy of edentulous alveolar ridge (K08.2) Compare K06.1 vs K08.2 →
- chronic gingivitis (K05.1) Compare K06.1 vs K05.1 →
- gingivitis NOS (K05.1) Compare K06.1 vs K05.1 →
Source: inherited from K06
Coder workflow for K06.1
MedCoder structured workflow — derived from this code’s own official record
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Official instructions as workflow
Excludes2 — not part of K06.1(4 notes)
Coding workflow: The conditions named in this note are not included in K06.1. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
See the official tabular notes · Guidelines I.A.12.b
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Coding context
Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Official Coding Guidelines
No excerpt in the ICD-10-CM Official Guidelines names this code specifically. Its chapter carries only this chapter-wide note:
Chapter 11: Diseases of the Digestive System (K00-K95)
Reserved for future guideline expansion
Verify Before Coding
- No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.
Relationships & Classification
MedCoder-derived relationships — computed from published CMS and AHRQ datasets
Other codes that name K06.1 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
Referenced by 1 Excludes2 note: K13 — Other diseases of lip and oral mucosa (via K06.-).
These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.
MS-DRG Grouper Relationships (FY2027)
Potential MS-DRG participation — not a DRG assignment.
FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.
Named in the grouper logic of 6 MS-DRGs: DRG 011 (MDC PRE), DRG 012 (MDC PRE), DRG 013 (MDC PRE), DRG 157 (MDC 03), DRG 158 (MDC 03), DRG 159 (MDC 03).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):DIG002 — Disorders of teeth and gingiva (default); DEN001 — Any dental condition including traumatic injury; DEN002 — Nontraumatic dental conditions; DEN003 — Caries, periodontitis, and other preventable dental conditions.
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Related Codes
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Disorders of teeth and gingiva, Any dental condition including traumatic injury, Nontraumatic dental conditions, Caries, periodontitis, and other preventable dental conditions).
K05.6 — Periodontal disease, unspecified, K06.0 — Gingival recession, K06.010 — Localized gingival recession, unspecified, K06.011 — Localized gingival recession, minimal, K06.012 — Localized gingival recession, moderate, K06.013 — Localized gingival recession, severe, K06.020 — Generalized gingival recession, unspecified, K06.021 — Generalized gingival recession, minimal, K06.022 — Generalized gingival recession, moderate, K06.023 — Generalized gingival recession, severe, K06.2 — Gingival and edentulous alveolar ridge lesions associated with trauma, K06.3 — Horizontal alveolar bone loss, K06.8 — Other specified disorders of gingiva and edentulous alveolar ridge, K06.9 — Disorder of gingiva and edentulous alveolar ridge, unspecified, K08.0 — Exfoliation of teeth due to systemic causes, K08.101 — Complete loss of teeth, unspecified cause, class I, K08.102 — Complete loss of teeth, unspecified cause, class II, K08.103 — Complete loss of teeth, unspecified cause, class III, K08.104 — Complete loss of teeth, unspecified cause, class IV, K08.109 — Complete loss of teeth, unspecified cause, unspecified class, +613 more
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Enlargement, enlarged”, “Hypertrophy, hypertrophic”, “Hyperplasia, hyperplastic”; these codes share that main term but sit in a different category of the Tabular List.
J33.9 — Nasal polyp, unspecified (nose, polypoid), J34.3 — Hypertrophy of nasal turbinates (nasal, turbinate), J34.89 — Other specified disorders of nose and nasal sinuses (nasal), J35.1 — Hypertrophy of tonsils (tonsils), J35.2 — Hypertrophy of adenoids (adenoids), J35.3 — Hypertrophy of tonsils with hypertrophy of adenoids (tonsils, with adenoids), J38.3 — Other diseases of vocal cords (vocal cord), J39.2 — Other diseases of pharynx (pharynx), J84.841 — Neuroendocrine cell hyperplasia of infancy (neuroendocrine cell, of infancy), K03.4 — Hypercementosis (cementation), K08.89 — Other specified disorders of teeth and supporting structures (alveolar ridge), K11.1 — Hypertrophy of salivary gland (parotid gland), K13.0 — Diseases of lips (lip), K13.29 — Other disturbances of oral epithelium, including tongue (epithelial, tongue), K13.6 — Irritative hyperplasia of oral mucosa (oral mucosa), K13.79 — Other lesions of oral mucosa (uvula), K14.3 — Hypertrophy of tongue papillae (tongue, papillae), K14.8 — Other diseases of tongue (tongue), K29.60 — Other gastritis without bleeding (gastric mucosa), K29.61 — Other gastritis with bleeding (gastric mucosa, with bleeding), +142 more
Contextual Map
Every relationship of K06.1 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Run K06.1 with this related code in Claim Check
Hierarchy
- K00-K95 — Chapter 11: Diseases of the Digestive System (K00-K95) (K00-K95)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- K00-K14 — Diseases of oral cavity and salivary glands[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
Referenced by Excludes2 notes
- K13 — Other diseases of lip and oral mucosa[Excludes2](via K06.-): “certain disorders of gingiva and edentulous alveolar ridge (K05-K06)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
Clinical classification (CCSR)
- DIG002 — Disorders of teeth and gingiva[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
- DEN001 — Any dental condition including traumatic injury[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
- DEN002 — Nontraumatic dental conditions[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
- DEN003 — Caries, periodontitis, and other preventable dental conditions[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
MS-DRG Grouper
- DRG 011 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC[MS-DRG]: “TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC (MDC PRE)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 012 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC[MS-DRG]: “TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC (MDC PRE)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 013 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC[MS-DRG]: “TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC (MDC PRE)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 157 — DENTAL AND ORAL DISEASES WITH MCC[MS-DRG]: “DENTAL AND ORAL DISEASES WITH MCC (MDC 03)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 158 — DENTAL AND ORAL DISEASES WITH CC[MS-DRG]: “DENTAL AND ORAL DISEASES WITH CC (MDC 03)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 159 — DENTAL AND ORAL DISEASES WITHOUT CC/MCC[MS-DRG]: “DENTAL AND ORAL DISEASES WITHOUT CC/MCC (MDC 03)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
MDC crossing
- Pre-MDC[MDC crossing]: “Pre-MDC — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 175 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
- MDC 03 — Diseases and Disorders of the Ear, Nose, Mouth and Throat[MDC crossing]: “Diseases and Disorders of the Ear, Nose, Mouth and Throat — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 5,151 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
Index entries
- Enlargement, enlarged, gingival[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
- Fibromatosis, gingival[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
- Hyperplasia, hyperplastic, gingiva[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
- Hyperplasia, hyperplastic, gum[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
- Hypertrophy, hypertrophic, gum (mucous membrane)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
- Hypertrophy, hypertrophic, mucous membrane, gum[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
Nearest codes (16)
- K06 — Other disorders of gingiva and edentulous alveolar ridge[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- K06.0 — Gingival recession[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- K06.01 — Gingival recession, localized[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- K06.010 — Localized gingival recession, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- K06.011 — Localized gingival recession, minimal[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- K06.012 — Localized gingival recession, moderate[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- K06.013 — Localized gingival recession, severe[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- K06.02 — Gingival recession, generalized[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- and 8 more
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Reference
Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.
Indexed Clinical Terms (6)
Official source data — entries quoted as published, in the Index’s own lookup phrasing
Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
- Coding guidelines Official source data
- ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
- Inpatient payment groups Official source data
- CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder-derived relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder editorial explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources
Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "K06.1 — Gingival enlargement." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/k06.1-gingival-enlargement
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionGingival enlargement
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to K06.1 in its code family, with their registry titles.
- K06.013 — Localized gingival recession, severe
- K06.02 — Gingival recession, generalized
- K06.020 — Generalized gingival recession, unspecified
- K06.021 — Generalized gingival recession, minimal
- K06.022 — Generalized gingival recession, moderate
- K06.023 — Generalized gingival recession, severe
- K06.2 — Gingival and edentulous alveolar ridge lesions associated with trauma
- K06.3 — Horizontal alveolar bone loss
- K06.8 — Other specified disorders of gingiva and edentulous alveolar ridge
- K06.9 — Disorder of gingiva and edentulous alveolar ridge, unspecified