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ICD-10 Guide
ICD-10 CodesK08.402

K08.402

Billable

Partial loss of teeth, unspecified cause, class II

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K08.402 is a billable code used to indicate a diagnosis of partial loss of teeth, unspecified cause, class ii.

Key Diagnostic Point:

K08.402 refers to partial loss of teeth due to an unspecified cause, classified as Class II. This condition typically presents with the loss of one or more teeth, which can significantly impact the patient's ability to chew and speak, leading to potential nutritional deficiencies and psychosocial issues. The anatomy involved includes the dental structures, such as the alveolar bone, gums, and surrounding soft tissues. The disease progression may vary based on underlying factors such as periodontal disease, trauma, or developmental anomalies. Diagnostic considerations include a thorough dental examination, radiographic imaging to assess bone loss, and evaluation of the patient's medical history to identify potential causes. Treatment may involve restorative dentistry, such as crowns or bridges, and addressing any underlying conditions contributing to tooth loss. Understanding the patient's overall health and dental hygiene practices is crucial for effective management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires a comprehensive dental evaluation.
  • Treatment complexity: Moderate, involving various restorative options.
  • Documentation requirements: Requires detailed clinical notes and imaging reports.
  • Coding specificity: Moderate, as it specifies partial loss without a defined cause.

Audit Risk Factors

  • Common coding errors: Misclassification of the cause of tooth loss.
  • Documentation gaps: Incomplete dental history or lack of imaging.
  • Billing challenges: Potential denials due to insufficient documentation of the condition.

Specialty Focus

Medical Specialties

Primary medical specialty: Dentistry

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Secondary specialty: Oral and Maxillofacial Surgery

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K08.402 lies in its potential to affect a patient's quality of life, including difficulties in eating and speaking, which can lead to nutritional deficiencies and social withdrawal. Population health impact includes the prevalence of dental issues in various demographics, highlighting the need for preventive care and education. Quality measures may focus on the effectiveness of interventions to restore dental function and improve overall health outcomes, while healthcare utilization patterns may reflect increased visits to dental professionals for restorative care.

ICD-9 vs ICD-10

The clinical significance of K08.402 lies in its potential to affect a patient's quality of life, including difficulties in eating and speaking, which can lead to nutritional deficiencies and social withdrawal. Population health impact includes the prevalence of dental issues in various demographics, highlighting the need for preventive care and education. Quality measures may focus on the effectiveness of interventions to restore dental function and improve overall health outcomes, while healthcare utilization patterns may reflect increased visits to dental professionals for restorative care.

Reimbursement & Billing Impact

reimbursement and to maintain clear communication with insurance providers regarding the patient's condition and treatment rationale.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K08.402?

K08.402 covers partial loss of teeth from various unspecified causes, including but not limited to periodontal disease, trauma, or congenital conditions. It is essential to document the clinical findings that led to the diagnosis.

When should K08.402 be used instead of related codes?

K08.402 should be used when there is partial loss of teeth without a clear etiology. If the cause is known, such as trauma or disease, the corresponding specific code should be selected.

What documentation supports K08.402?

Documentation should include a comprehensive dental examination, patient history, radiographic evidence of tooth loss, and any relevant treatment plans or referrals to specialists.