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ICD-10 Guide
ICD-10 CodesK02.62

K02.62

Billable

Dental caries on smooth surface penetrating into dentin

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

Code Description

ICD-10 K02.62 is a billable code used to indicate a diagnosis of dental caries on smooth surface penetrating into dentin.

Key Diagnostic Point:

K02.62 refers to dental caries on the smooth surface of teeth that has progressed to penetrate into the dentin layer. Clinically, this condition presents as a cavity or decay that is often asymptomatic in its early stages but can lead to sensitivity, pain, and further complications if left untreated. The anatomy involved includes the enamel, which is the outer protective layer of the tooth, and the dentin, which is the underlying layer that contains nerve endings and is more susceptible to decay. Disease progression typically starts with demineralization of the enamel, leading to the formation of a cavity that extends into the dentin. Diagnostic considerations include visual examination, radiographic imaging, and possibly the use of diagnostic tools to assess the extent of decay. Early detection and intervention are crucial to prevent further deterioration and potential complications such as pulpitis or abscess formation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and possibly imaging.
  • Treatment complexity: May involve restorative procedures such as fillings or crowns.
  • Documentation requirements: Detailed records of clinical findings and treatment plans are necessary.
  • Coding specificity: Requires precise coding to differentiate from other types of caries.

Audit Risk Factors

  • Common coding errors: Misclassification of caries type or severity.
  • Documentation gaps: Incomplete records of clinical findings or treatment rationale.
  • Billing challenges: Potential denials if documentation does not support the severity of the condition.

Specialty Focus

Medical Specialties

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

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K02.62 lies in its potential to lead to more severe dental issues if not addressed promptly. The prevalence of dental caries is high, impacting population health and healthcare utilization patterns. Effective management of dental caries can improve quality measures related to oral health and reduce the burden on healthcare systems. Epidemiologically, understanding the progression of dental caries can inform preventive strategies and public health initiatives aimed at reducing the incidence of dental diseases.

ICD-9 vs ICD-10

The clinical significance of K02.62 lies in its potential to lead to more severe dental issues if not addressed promptly. The prevalence of dental caries is high, impacting population health and healthcare utilization patterns. Effective management of dental caries can improve quality measures related to oral health and reduce the burden on healthcare systems. Epidemiologically, understanding the progression of dental caries can inform preventive strategies and public health initiatives aimed at reducing the incidence of dental diseases.

Reimbursement & Billing Impact

Reimbursement considerations include verifying patient eligibility and coverage for dental procedures. Common denials may arise from insufficient documentation or coding errors, so it is crucial to provide clear clinical notes and treatment plans. Best practices include using precise coding, maintaining thorough records, and ensuring that all services rendered are justified by the clinical findings documented in the patient's chart.

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 K02.62?

K02.62 specifically covers dental caries that have penetrated into the dentin on smooth surfaces of teeth. It does not include caries on occlusal surfaces or those that are limited to enamel.

When should K02.62 be used instead of related codes?

K02.62 should be used when there is clear evidence of caries that has progressed beyond the enamel into the dentin. If the caries is limited to the enamel, K02.61 should be used instead.

What documentation supports K02.62?

Documentation should include clinical findings from examinations, radiographic evidence showing the extent of decay, and treatment plans that outline the necessary restorative procedures.