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ICD-10 Guide
ICD-10 CodesK08.25

K08.25

Billable

Moderate atrophy of the maxilla

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

Code Description

ICD-10 K08.25 is a billable code used to indicate a diagnosis of moderate atrophy of the maxilla.

Key Diagnostic Point:

K08.25 refers to moderate atrophy of the maxilla, a condition characterized by the reduction in size and density of the maxillary bone, which can significantly impact oral function and aesthetics. The maxilla is a crucial component of the facial skeleton, providing structure to the face and supporting the upper teeth. Atrophy may result from various factors, including periodontal disease, tooth loss, trauma, or systemic conditions affecting bone metabolism. Clinically, patients may present with difficulties in chewing, speech, and may experience changes in facial appearance. The progression of maxillary atrophy can lead to further complications, such as malocclusion or temporomandibular joint disorders. Diagnostic considerations include clinical examination, imaging studies like panoramic radiographs or CT scans, and assessment of dental history. Understanding the underlying causes is essential for effective management and treatment planning, which may involve dental implants, bone grafting, or prosthetic rehabilitation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough evaluation of dental and medical history, imaging, and potential interdisciplinary consultation.
  • Treatment complexity: Management may involve surgical interventions or multidisciplinary approaches.
  • Documentation requirements: Detailed documentation of clinical findings, imaging results, and treatment plans is necessary.
  • Coding specificity: Requires precise coding to differentiate from other forms of maxillary atrophy or related conditions.

Audit Risk Factors

  • Common coding errors: Misclassification of the severity of atrophy.
  • Documentation gaps: Incomplete records regarding the extent of atrophy or treatment rationale.
  • Billing challenges: Potential denials due to insufficient documentation or lack of clear treatment plans.

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 K08.25 lies in its potential impact on oral function and quality of life for affected individuals. Population health considerations include the prevalence of maxillary atrophy in aging populations and those with dental disease, which can lead to increased healthcare utilization for restorative procedures. Quality measures may focus on timely diagnosis and effective management strategies to improve patient outcomes and reduce complications associated with maxillary atrophy.

ICD-9 vs ICD-10

The clinical significance of K08.25 lies in its potential impact on oral function and quality of life for affected individuals. Population health considerations include the prevalence of maxillary atrophy in aging populations and those with dental disease, which can lead to increased healthcare utilization for restorative procedures. Quality measures may focus on timely diagnosis and effective management strategies to improve patient outcomes and reduce complications associated with maxillary atrophy.

Reimbursement & Billing Impact

Reimbursement considerations include the need for detailed clinical notes, imaging results, and any procedural codes related to treatment. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for procedures performed. It is essential to ensure that all coding aligns with the documented clinical findings to minimize audit risks and ensure appropriate 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 K08.25?

K08.25 covers moderate atrophy of the maxilla, which may arise from conditions such as chronic periodontitis, tooth loss, or systemic diseases affecting bone density. It is essential to evaluate the patient's dental history and any contributing factors.

When should K08.25 be used instead of related codes?

K08.25 should be used when there is documented evidence of moderate atrophy of the maxilla, differentiating it from mild (K08.24) or severe (K08.26) atrophy based on clinical findings and imaging results.

What documentation supports K08.25?

Documentation should include clinical examination findings, imaging studies (e.g., X-rays or CT scans), treatment plans, and any relevant medical history that supports the diagnosis of moderate maxillary atrophy.