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ICD-10 Guide
ICD-10 CodesK08.113

K08.113

Billable

Complete loss of teeth due to trauma, class III

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

Code Description

ICD-10 K08.113 is a billable code used to indicate a diagnosis of complete loss of teeth due to trauma, class iii.

Key Diagnostic Point:

K08.113 refers to the complete loss of teeth due to trauma, classified as class III. This condition typically arises from significant physical injury to the oral cavity, resulting in the loss of all teeth in one or both dental arches. The anatomy involved includes the maxilla and mandible, as well as the periodontal structures that support the teeth. Clinically, patients may present with acute pain, swelling, and bleeding in the oral region, along with functional impairments such as difficulty in chewing and speaking. Disease progression can lead to complications such as malnutrition due to impaired dietary intake, as well as psychological impacts stemming from altered appearance and self-esteem issues. Diagnostic considerations include a thorough clinical examination, radiographic imaging to assess bone integrity, and possibly referral to dental specialists for comprehensive management. The diagnosis must be substantiated by documentation of the traumatic event and its direct correlation to the loss of teeth.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires detailed assessment of trauma and its effects on dental structures.
  • Treatment complexity: Involves multidisciplinary approaches including dental surgery, prosthodontics, and possibly psychological support.
  • Documentation requirements: Necessitates comprehensive records of trauma, treatment plans, and follow-up care.
  • Coding specificity: Requires precise coding to differentiate from other types of tooth loss, such as due to decay or periodontal disease.

Audit Risk Factors

  • Common coding errors: Misclassification of tooth loss due to trauma as loss due to other causes.
  • Documentation gaps: Incomplete records of the traumatic event or treatment plan.
  • Billing challenges: Potential denials if documentation does not clearly establish the cause of tooth loss.

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K08.113 is profound, as complete tooth loss can severely impact a patient's quality of life, affecting nutrition, speech, and psychological well-being. Population health impacts include increased healthcare utilization for dental and psychological services. Quality measures may focus on timely intervention and rehabilitation for affected individuals, while epidemiological considerations highlight the need for preventive measures in high-risk populations, such as athletes or individuals in high-risk occupations.

ICD-9 vs ICD-10

The clinical significance of K08.113 is profound, as complete tooth loss can severely impact a patient's quality of life, affecting nutrition, speech, and psychological well-being. Population health impacts include increased healthcare utilization for dental and psychological services. Quality measures may focus on timely intervention and rehabilitation for affected individuals, while epidemiological considerations highlight the need for preventive measures in high-risk populations, such as athletes or individuals in high-risk occupations.

Reimbursement & Billing Impact

Reimbursement considerations include the need for pre-authorization for surgical procedures and potential coverage limitations based on the cause of tooth loss. Common denials may arise from insufficient documentation linking the trauma to the tooth loss. Best practices include ensuring all clinical notes are thorough and that any imaging studies are included in the patient’s record to support the claim.

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 K08.113?

K08.113 specifically covers complete loss of teeth resulting from trauma, including accidents, sports injuries, or physical assaults. It does not cover tooth loss due to decay or periodontal disease.

When should K08.113 be used instead of related codes?

K08.113 should be used when there is clear documentation of complete tooth loss due to a traumatic event. It should not be used for tooth loss due to non-traumatic causes such as decay or periodontal disease.

What documentation supports K08.113?

Documentation must include a detailed account of the traumatic incident, clinical findings, treatment plans, and any referrals to specialists. Radiographic evidence may also be necessary to support the diagnosis.