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ICD-10 Guide
ICD-10 CodesK08.134

K08.134

Billable

Complete loss of teeth due to caries, class IV

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

Code Description

ICD-10 K08.134 is a billable code used to indicate a diagnosis of complete loss of teeth due to caries, class iv.

Key Diagnostic Point:

K08.134 refers to complete loss of teeth due to caries, class IV, which is a severe form of dental caries leading to total tooth loss. This condition primarily affects the oral cavity, specifically the teeth and surrounding structures. Class IV caries indicates extensive decay that has progressed beyond the enamel and dentin, often involving the pulp and resulting in significant tooth destruction. Clinically, patients may present with multiple missing teeth, pain, and difficulty in chewing, which can lead to nutritional deficiencies and gastrointestinal issues due to inadequate food intake. The disease progression typically starts with initial carious lesions that, if untreated, advance to deeper layers of the tooth, culminating in complete loss. Diagnostic considerations include clinical examination, radiographic evaluation, and patient history to assess the extent of caries and associated factors such as oral hygiene practices and dietary habits. This condition is significant as it can lead to further complications, including periodontal disease and systemic health issues related to poor nutrition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough dental evaluation and imaging.
  • Treatment complexity: May involve multiple dental interventions including extractions and prosthetics.
  • Documentation requirements: Detailed records of dental history, treatment plans, and patient compliance.
  • Coding specificity: Specific to complete loss of teeth due to caries, necessitating accurate coding.

Audit Risk Factors

  • Common coding errors: Misclassification of the severity of caries.
  • Documentation gaps: Incomplete records of dental evaluations and treatment plans.
  • Billing challenges: Potential denials due to lack of supporting documentation for the severity 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 K08.134 extends beyond dental health, as complete tooth loss can lead to nutritional deficiencies and gastrointestinal complications due to impaired chewing. This condition can affect population health by increasing the risk of systemic diseases associated with poor nutrition. Quality measures may include monitoring the prevalence of tooth loss due to caries and assessing the effectiveness of preventive dental care programs. Understanding healthcare utilization patterns related to this condition can help in developing targeted interventions to improve oral health outcomes.

ICD-9 vs ICD-10

The clinical significance of K08.134 extends beyond dental health, as complete tooth loss can lead to nutritional deficiencies and gastrointestinal complications due to impaired chewing. This condition can affect population health by increasing the risk of systemic diseases associated with poor nutrition. Quality measures may include monitoring the prevalence of tooth loss due to caries and assessing the effectiveness of preventive dental care programs. Understanding healthcare utilization patterns related to this condition can help in developing targeted interventions to improve oral health outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the need for prior authorization for extensive dental procedures and ensuring that all services rendered are well-documented to avoid denials. Common denials may arise from insufficient documentation or incorrect coding, so it is crucial to maintain accurate records of all dental evaluations and treatments. Best practices include using clear, specific language in documentation and ensuring that all claims are submitted with the appropriate codes and modifiers.

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 K08.134?

K08.134 specifically covers complete loss of teeth due to severe caries classified as class IV. This includes cases where extensive decay has led to the total loss of teeth, impacting the patient's ability to chew and affecting overall health.

When should K08.134 be used instead of related codes?

K08.134 should be used when there is a complete loss of teeth due to class IV caries. It is important to differentiate this from partial tooth loss or loss due to other causes, such as trauma or periodontal disease.

What documentation supports K08.134?

Documentation should include a comprehensive dental examination, radiographic evidence showing the extent of caries, treatment history, and any relevant patient symptoms or complaints related to oral health.