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ICD-10 Guide
ICD-10 CodesK06.023

K06.023

Billable

Generalized gingival recession, severe

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

Code Description

ICD-10 K06.023 is a billable code used to indicate a diagnosis of generalized gingival recession, severe.

Key Diagnostic Point:

Generalized gingival recession, severe, is characterized by the apical migration of the gingival margin, leading to exposure of the tooth roots. This condition can result from various factors, including periodontal disease, aggressive tooth brushing, or anatomical predispositions. Clinically, patients may present with sensitivity to temperature changes, aesthetic concerns, and increased risk of root caries. The anatomy involved primarily includes the gingiva, periodontal ligament, and the underlying alveolar bone. Disease progression can lead to further periodontal issues if not addressed, as the exposed roots may become susceptible to decay and further recession. Diagnostic considerations include a thorough clinical examination, periodontal probing, and radiographic evaluation to assess the extent of periodontal attachment loss and bone support. Early intervention is crucial to prevent complications and improve oral health outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires a comprehensive evaluation of periodontal health and potential underlying causes.
  • Treatment complexity: May involve non-surgical and surgical interventions, including scaling, root planing, and grafting procedures.
  • Documentation requirements: Detailed clinical notes and treatment plans are essential for accurate coding and reimbursement.
  • Coding specificity: Requires precise documentation of the severity and extent of gingival recession.

Audit Risk Factors

  • Common coding errors: Misclassification of the severity of gingival recession.
  • Documentation gaps: Incomplete records regarding the extent of recession and treatment plans.
  • Billing challenges: Potential denials if documentation does not support the severity or necessity of procedures performed.

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

Periodontology

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

Severe generalized gingival recession can significantly impact oral health, leading to increased sensitivity, aesthetic concerns, and a higher risk of dental caries. It affects a considerable portion of the population, particularly those with poor oral hygiene or periodontal disease. Addressing this condition is essential for improving quality measures in dental care and reducing healthcare utilization associated with advanced periodontal treatments.

ICD-9 vs ICD-10

Severe generalized gingival recession can significantly impact oral health, leading to increased sensitivity, aesthetic concerns, and a higher risk of dental caries. It affects a considerable portion of the population, particularly those with poor oral hygiene or periodontal disease. Addressing this condition is essential for improving quality measures in dental care and reducing healthcare utilization associated with advanced periodontal treatments.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the gingival recession and the complexity of the treatment plan. Common denials may arise if the documentation does not clearly support the diagnosis or the necessity of surgical interventions. Coders should ensure that all relevant clinical notes, treatment plans, and procedural codes are accurately recorded to facilitate proper reimbursement and minimize audit risks.

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 K06.023?

K06.023 specifically covers severe generalized gingival recession, which may be associated with periodontal disease, trauma, or anatomical factors leading to significant root exposure.

When should K06.023 be used instead of related codes?

K06.023 should be used when there is clear evidence of severe generalized gingival recession, as indicated by clinical findings and diagnostic imaging, differentiating it from moderate or localized conditions.

What documentation supports K06.023?

Documentation should include clinical examination findings, periodontal probing depths, extent of recession, treatment plans, and any relevant imaging studies that support the diagnosis of severe generalized gingival recession.