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ICD-10 Guide
ICD-10 CodesK08.19

K08.19

Non-billable

Complete loss of teeth due to other specified cause

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

Code Description

ICD-10 K08.19 is a used to indicate a diagnosis of complete loss of teeth due to other specified cause.

Key Diagnostic Point:

K08.19 refers to the complete loss of teeth due to other specified causes, which can include a variety of conditions affecting the oral cavity and surrounding structures. Clinically, this may present as total edentulism, where patients experience the absence of all natural teeth, impacting their ability to chew, speak, and maintain proper nutrition. The anatomy involved primarily includes the maxilla and mandible, along with associated periodontal tissues. Disease progression can be influenced by factors such as periodontal disease, trauma, systemic diseases (like diabetes), or certain medications that may lead to tooth loss. Diagnostic considerations include thorough dental examinations, radiographic assessments, and patient history to identify underlying causes. It is essential to differentiate K08.19 from other codes related to tooth loss, such as those specifically related to periodontal disease or trauma, to ensure accurate coding and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation of underlying causes.
  • Treatment complexity: May involve multidisciplinary approaches including dental, medical, and nutritional interventions.
  • Documentation requirements: Detailed documentation of the cause of tooth loss and treatment plan is necessary.
  • Coding specificity: Requires precise identification of the cause to differentiate from other tooth loss codes.

Audit Risk Factors

  • Common coding errors: Misclassification of tooth loss causes.
  • Documentation gaps: Incomplete patient history or lack of diagnostic evidence.
  • Billing challenges: Potential denials if documentation does not support the specified cause.

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 K08.19 lies in its association with various systemic conditions that can affect overall health and nutrition. The population health impact is notable, as complete tooth loss can lead to increased healthcare utilization due to complications such as malnutrition and social isolation. Quality measures may include monitoring the prevalence of tooth loss in populations and the effectiveness of preventive measures. Epidemiologically, understanding the causes of tooth loss can inform public health initiatives aimed at improving oral health outcomes.

ICD-9 vs ICD-10

The clinical significance of K08.19 lies in its association with various systemic conditions that can affect overall health and nutrition. The population health impact is notable, as complete tooth loss can lead to increased healthcare utilization due to complications such as malnutrition and social isolation. Quality measures may include monitoring the prevalence of tooth loss in populations and the effectiveness of preventive measures. Epidemiologically, understanding the causes of tooth loss can inform public health initiatives aimed at improving oral health outcomes.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the underlying cause and associated treatments. Common denials may arise from insufficient documentation or misclassification of the cause of tooth loss. Best practices include thorough documentation of patient history, diagnostic findings, and treatment plans to support claims and reduce the risk of audits.

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 K08.19?

K08.19 covers complete loss of teeth due to conditions such as systemic diseases (e.g., diabetes), trauma, or other specified causes that do not fall under periodontal disease or congenital conditions.

When should K08.19 be used instead of related codes?

K08.19 should be used when the complete loss of teeth is attributed to causes other than periodontal disease or trauma, ensuring that the specific underlying condition is documented.

What documentation supports K08.19?

Documentation should include a comprehensive dental examination, patient history detailing the cause of tooth loss, and any relevant diagnostic tests that support the diagnosis.