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ICD-10 Guide
ICD-10 CodesK08.133

K08.133

Billable

Complete loss of teeth due to caries, class III

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

Code Description

ICD-10 K08.133 is a billable code used to indicate a diagnosis of complete loss of teeth due to caries, class iii.

Key Diagnostic Point:

K08.133 refers to complete loss of teeth due to caries, class III, which is characterized by extensive decay leading to the total loss of teeth. This condition primarily affects the oral cavity, particularly the dentition, which includes the teeth and supporting structures. The disease progression typically begins with the formation of dental caries, which are localized areas of decay caused by bacterial action on carbohydrates. If left untreated, caries can progress to pulpitis and eventually result in tooth loss. Diagnostic considerations for K08.133 include clinical examination, radiographic evaluation, and patient history to assess the extent of carious lesions and overall oral health. Patients may present with symptoms such as pain, difficulty chewing, and aesthetic concerns. The complete loss of teeth can significantly impact a patient's quality of life, leading to nutritional deficiencies and psychological effects. Therefore, timely diagnosis and intervention are crucial to prevent further complications and to manage the patient's oral health effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation of dental health and caries progression.
  • Treatment complexity: Involves potential restorative procedures, prosthodontics, or oral surgery.
  • Documentation requirements: Detailed records of dental examinations, treatment plans, and patient history are essential.
  • Coding specificity: Requires precise coding to differentiate from other dental conditions.

Audit Risk Factors

  • Common coding errors: Misclassification of tooth loss severity or failure to document the cause.
  • Documentation gaps: Incomplete patient records or lack of evidence for caries progression.
  • Billing challenges: Potential denials due to insufficient documentation or incorrect coding.

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 K08.133 lies in its potential to affect overall health, as complete tooth loss can lead to difficulties in nutrition and social interactions. Population health impact includes increased prevalence of dental diseases and associated healthcare costs. Quality measures may focus on preventive care and early intervention strategies to reduce the incidence of caries-related tooth loss. Understanding healthcare utilization patterns related to this condition can inform public health initiatives aimed at improving oral health outcomes and reducing the burden of dental diseases.

ICD-9 vs ICD-10

The clinical significance of K08.133 lies in its potential to affect overall health, as complete tooth loss can lead to difficulties in nutrition and social interactions. Population health impact includes increased prevalence of dental diseases and associated healthcare costs. Quality measures may focus on preventive care and early intervention strategies to reduce the incidence of caries-related tooth loss. Understanding healthcare utilization patterns related to this condition can inform public health initiatives aimed at improving oral health outcomes and reducing the burden of dental diseases.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of procedures performed, such as extractions or prosthetic replacements. Common denials may arise from inadequate documentation or failure to demonstrate medical necessity. Coders should ensure that all relevant information is included in the claim to support the diagnosis and treatment provided, adhering to payer-specific guidelines for optimal reimbursement.

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 K08.133?

K08.133 covers complete loss of teeth due to caries classified as class III, indicating severe decay leading to total tooth loss. It is essential to document the extent of caries and any contributing factors such as poor oral hygiene or systemic conditions.

When should K08.133 be used instead of related codes?

K08.133 should be used when there is a complete loss of teeth specifically due to caries, as opposed to partial loss or loss due to other etiologies. Proper differentiation is crucial for accurate coding and treatment planning.

What documentation supports K08.133?

Documentation should include comprehensive dental examinations, radiographic findings showing carious lesions, treatment history, and patient complaints related to oral health. Detailed notes on the progression of caries and any interventions attempted are also necessary.