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ICD-10 Guide
ICD-10 CodesK06.3

K06.3

Billable

Horizontal alveolar bone loss

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

Code Description

ICD-10 K06.3 is a billable code used to indicate a diagnosis of horizontal alveolar bone loss.

Key Diagnostic Point:

Horizontal alveolar bone loss refers to the reduction of the alveolar bone height in a horizontal plane, primarily affecting the dental arches. This condition is often associated with periodontal disease, where inflammation and infection lead to the destruction of the supporting structures of the teeth. Clinically, patients may present with gum recession, tooth mobility, and increased pocket depths during periodontal examinations. The anatomy involved includes the alveolar bone, which houses the tooth roots, and the surrounding periodontal tissues. Disease progression can vary, with factors such as oral hygiene, systemic health conditions, and genetic predispositions influencing the rate of bone loss. Diagnostic considerations include clinical assessments, radiographic evaluations, and periodontal probing to determine the extent of bone loss and its impact on dental health. Early detection and intervention are crucial to prevent further deterioration and to maintain oral function.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough periodontal evaluation and radiographic interpretation.
  • Treatment complexity: May involve non-surgical and surgical interventions, including scaling, root planing, and regenerative procedures.
  • Documentation requirements: Detailed clinical notes and radiographic evidence are essential for accurate coding.
  • Coding specificity: Requires precise documentation of the extent and severity of bone loss.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of bone loss or failure to document the extent.
  • Documentation gaps: Incomplete clinical notes or lack of supporting radiographs.
  • Billing challenges: Potential denials due to insufficient documentation or incorrect coding.

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

The clinical significance of K06.3 lies in its association with periodontal disease, which can lead to tooth loss and impact overall health. Population health impact includes increased healthcare utilization for dental treatments and potential systemic health implications, as periodontal disease has been linked to conditions such as diabetes and cardiovascular disease. Quality measures may focus on the prevention and management of periodontal disease, emphasizing the importance of regular dental check-ups and effective oral hygiene practices.

ICD-9 vs ICD-10

The clinical significance of K06.3 lies in its association with periodontal disease, which can lead to tooth loss and impact overall health. Population health impact includes increased healthcare utilization for dental treatments and potential systemic health implications, as periodontal disease has been linked to conditions such as diabetes and cardiovascular disease. Quality measures may focus on the prevention and management of periodontal disease, emphasizing the importance of regular dental check-ups and effective oral hygiene practices.

Reimbursement & Billing Impact

Reimbursement considerations include the patient's insurance coverage for periodontal procedures, which may vary significantly. Common denials can arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include ensuring that all clinical findings, treatment plans, and patient consent forms are meticulously documented to support the coding and billing process.

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 K06.3?

K06.3 encompasses conditions related to horizontal alveolar bone loss due to periodontal disease, trauma, or other factors leading to bone resorption. It is important to differentiate it from localized bone loss, which may have different etiologies and treatment approaches.

When should K06.3 be used instead of related codes?

K06.3 should be used when there is evidence of horizontal bone loss affecting multiple teeth, particularly in the context of periodontal disease. If the bone loss is localized to specific areas, K06.2 may be more appropriate.

What documentation supports K06.3?

Documentation should include periodontal examination findings, radiographic images showing the extent of bone loss, and treatment plans. Detailed notes on patient history, oral hygiene practices, and any systemic conditions affecting periodontal health are also necessary.