ICD-10-CM · Other

M26.07

M26.07 identifies an abnormal overgrowth of the maxillary tuberosity — the bony prominence at the posterior end of the upper jaw — classified as a dentofacial anomaly under the musculoskeletal chapter.

Verified May 8, 2026 · 5 sources ↓

Status
Billable
Chapter
13
Related CPT
3
Region
Other
Drawn from CDCCMSICD10DataAAPC

Documentation tips

What should appear in the chart to support M26.07.

Source · Editorial brief grounded in 5 cited references ↓

  • Provider must explicitly document 'excessive,' 'enlarged,' or 'hypertrophic' maxillary tuberosity — a generic jaw anomaly note is insufficient to support M26.07 specificity.
  • Record any imaging findings (periapical, panoramic, or CBCT) that confirm bony overgrowth dimensions and extent of the tuberosity.
  • Document the clinical impact — interference with denture fabrication, occlusal discrepancy, or soft tissue impingement — to support medical necessity for any planned surgical reduction.
  • If the tuberosity finding is bilateral, note both sides in the record; M26.07 has no laterality subcode, but the operative note must specify which side(s) are treated.
  • Confirm the anomaly is not attributable to acromegaly (E22.0) or Robin's syndrome (Q87.0); if either is present, the Excludes1 note at M26.0 prohibits simultaneous use of M26.07.

Related CPT procedures

Procedure codes commonly billed with M26.07. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

Common coding pitfalls

The recurring mistakes coders make with M26.07 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

  • Coding M26.07 alongside E22.0 (acromegaly) violates the Excludes1 note at the M26.0 category level — acromegaly-driven jaw enlargement codes to E22.0 only.
  • Confusing excessive tuberosity (M26.07) with other M26.0 subcodes such as macrognathia (M26.05) or mandibular hyperplasia (M26.03) — the tuberosity is a specific anatomical site, not generalized jaw enlargement.
  • Assigning M26.07 based solely on a patient complaint without provider-documented clinical or radiographic confirmation of bony overgrowth risks a medical necessity denial.
  • Omitting M26.07 as the supporting diagnosis on a claim for tuberosity reduction surgery, leaving the procedure without a linked ICD-10 code that justifies medical necessity.

Clinical context

Source · Editorial summary grounded in 5 cited references ↓

M26.07 applies when a provider documents excessive or enlarged maxillary tuberosity, whether identified incidentally on imaging, during pre-prosthetic workup, or as the primary finding driving a surgical reduction procedure. The condition is relevant in oral and maxillofacial surgery, prosthodontic, and periodontology contexts where an overgrown tuberosity interferes with denture seating, occlusion, or adjacent tissue health.

The code sits under parent M26.0 (major anomalies of jaw size) within the M26–M27 dentofacial anomaly section of Chapter 13. Note the Excludes1 restrictions at the category level: acromegaly (E22.0) and Robin's syndrome (Q87.0) are excluded — if either condition is the documented underlying cause of jaw size change, M26.07 is not appropriate.

M26.07 carries no laterality distinction and no 7th-character extension requirement. It is a stand-alone billable code. When the encounter involves surgical reduction of the tuberosity, M26.07 is the supporting diagnosis; pair it with the appropriate CPT procedure code for tuberosity reduction or alveoloplasty.

Inclusion & exclusion notes

Per the official ICD-10-CM Tabular List.

Source · CDC ICD-10-CM Official Tabular List · 2026

Includes

  • Entire maxillary tuberosity

Sibling codes

Other billable codes under M26.0 (laterality / anatomic variants).

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01Is M26.07 specific to the maxilla, or does it cover tuberosity overgrowth elsewhere in the jaw?
M26.07 is specific to the maxillary tuberosity. The AAPC long descriptor note confirms this: 'Entire maxillary tuberosity.' Overgrowth of mandibular bony prominences would require a different code or an unspecified M26.09 if no specific code applies.
02Can M26.07 be used when the tuberosity finding is incidental and no surgery is planned?
Yes. M26.07 is billable whenever excessive maxillary tuberosity is documented as a diagnosis, regardless of whether surgical intervention is planned. If it is an incidental finding not driving the encounter, list it as a secondary code.
03What happens if the patient also has acromegaly causing jaw enlargement?
The Excludes1 note at M26.0 prohibits coding M26.07 alongside E22.0 (acromegaly). When acromegaly is the documented cause of jaw size change, code E22.0 and do not assign M26.07.
04Does M26.07 require a 7th-character extension?
No. M26.07 is a 5-character code with no 7th-character extension requirement. 7th-character extensions for encounter type (A/D/S) apply to injury S-codes, not to musculoskeletal anomaly M-codes.
05Which CPT codes are commonly paired with M26.07 as the supporting diagnosis?
Tuberosity reduction (alveoloplasty) and excision of bony exostosis of the maxillary alveolar ridge are the procedures most directly supported by M26.07. CPT 21032 (excision of maxillary torus palatinus) and 41899 (unlisted procedure, dentoalveolar structures) are commonly referenced, depending on payer and procedure specifics.
06Is there a laterality distinction within M26.07 for unilateral versus bilateral tuberosity?
No. M26.07 carries no laterality subcode. Document affected side(s) in the clinical record and operative note, but the ICD-10-CM code itself does not differentiate right, left, or bilateral.

Mira AI Scribe

The Mira AI Scribe captures the provider's explicit characterization of the maxillary tuberosity (excessive, enlarged, hypertrophic), any imaging modality and findings confirming bony overgrowth, the functional consequence documented (denture interference, occlusal disruption, soft tissue impingement), and confirmation that acromegaly or Robin's syndrome are not the underlying etiology. This prevents an unspecified jaw anomaly code being assigned in place of M26.07, which can trigger a medical necessity flag and delay reimbursement for tuberosity reduction procedures.

See how Mira captures M26.07 documentation

Related ICD-10 codes

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