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ICD-10 Guide
ICD-10 CodesK06.010

K06.010

Billable

Localized gingival recession, unspecified

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

Code Description

ICD-10 K06.010 is a billable code used to indicate a diagnosis of localized gingival recession, unspecified.

Key Diagnostic Point:

Localized gingival recession, unspecified, refers to the condition where the gum tissue surrounding the teeth recedes, exposing the roots of the teeth. This condition can occur due to various factors, including periodontal disease, aggressive tooth brushing, or anatomical predispositions. Clinically, patients may present with sensitivity to temperature changes, increased tooth mobility, and aesthetic concerns. The anatomy involved primarily includes the gingiva, which is the soft tissue that surrounds the teeth, and the underlying alveolar bone. Disease progression can lead to further recession, potential tooth loss, and increased risk of root caries. Diagnostic considerations include a thorough clinical examination, periodontal probing, and radiographic evaluation to assess the extent of recession and any associated periodontal disease. Treatment options may vary from conservative measures, such as improved oral hygiene and desensitizing agents, to surgical interventions like gum grafting, depending on the severity and underlying causes of the recession.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of periodontal disease and gingival anatomy.
  • Treatment complexity: Options range from conservative to surgical, necessitating interdisciplinary care.
  • Documentation requirements: Detailed records of clinical findings and treatment plans are essential.
  • Coding specificity: While K06.010 is specific, related codes may require differentiation based on the extent and cause of recession.

Audit Risk Factors

  • Common coding errors: Misidentifying the extent of recession or failing to document the cause.
  • Documentation gaps: Incomplete records of patient history and treatment rationale.
  • Billing challenges: Potential denials if documentation does not support the necessity of procedures performed.

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: Periodontics

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

Localized gingival recession can significantly affect oral health, leading to increased sensitivity, aesthetic concerns, and potential tooth loss. Its prevalence highlights the need for effective preventive measures and treatment strategies. Understanding the epidemiology of gingival recession can inform public health initiatives aimed at improving oral hygiene practices and reducing the incidence of periodontal diseases.

ICD-9 vs ICD-10

Localized gingival recession can significantly affect oral health, leading to increased sensitivity, aesthetic concerns, and potential tooth loss. Its prevalence highlights the need for effective preventive measures and treatment strategies. Understanding the epidemiology of gingival recession can inform public health initiatives aimed at improving oral hygiene practices and reducing the incidence of periodontal diseases.

Reimbursement & Billing Impact

Reimbursement considerations include verifying patient eligibility and understanding the payer's policies regarding periodontal treatments. Common denials may arise from insufficient documentation or lack of medical necessity. Best practices include maintaining comprehensive records of clinical findings, treatment plans, and patient communications to support claims and reduce the risk of audits.

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 K06.010?

K06.010 covers localized gingival recession without specifying the cause. It may arise from periodontal disease, trauma, or anatomical factors. Clinicians should assess the underlying causes to determine appropriate treatment.

When should K06.010 be used instead of related codes?

K06.010 should be used when the gingival recession is localized and the cause is unspecified. If the recession is generalized or associated with specific periodontal disease, other codes may be more appropriate.

What documentation supports K06.010?

Documentation should include a detailed clinical examination, periodontal probing depths, patient history, and any relevant radiographs. Treatment plans and patient consent for procedures should also be documented.