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ICD-10 Guide
ICD-10 CodesK08.404

K08.404

Billable

Partial loss of teeth, unspecified cause, class IV

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

Code Description

ICD-10 K08.404 is a billable code used to indicate a diagnosis of partial loss of teeth, unspecified cause, class iv.

Key Diagnostic Point:

K08.404 refers to partial loss of teeth due to unspecified causes, classified as class IV. This condition can significantly impact the oral cavity, affecting the anatomy of the teeth and surrounding structures. Clinically, patients may present with difficulty in chewing, altered speech, and aesthetic concerns. The progression of this condition can lead to further dental complications, including misalignment of remaining teeth, increased risk of periodontal disease, and potential impacts on the gastrointestinal system due to impaired mastication. Diagnostic considerations include a thorough dental examination, radiographic imaging, and patient history to rule out underlying conditions such as trauma, periodontal disease, or systemic diseases that may contribute to tooth loss. Understanding the etiology is crucial for developing an appropriate treatment plan, which may involve restorative dentistry, prosthodontics, or oral surgery.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive dental evaluation and possibly interdisciplinary consultation.
  • Treatment complexity: May involve multiple specialties including dentistry, oral surgery, and possibly nutrition.
  • Documentation requirements: Detailed clinical notes and imaging reports are necessary to support the diagnosis.
  • Coding specificity: Requires precise coding to differentiate from other dental conditions.

Audit Risk Factors

  • Common coding errors: Misclassification of the cause of tooth loss.
  • Documentation gaps: Incomplete patient history or lack of imaging to support diagnosis.
  • Billing challenges: Potential denials if documentation does not clearly establish the necessity for treatment.

Specialty Focus

Medical Specialties

Primary medical specialty: 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

Secondary specialty: 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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K08.404 lies in its potential to affect a patient's quality of life, including difficulties in eating and speaking, which can lead to nutritional deficiencies and social withdrawal. Population health impacts include increased healthcare utilization for dental care and potential systemic health issues related to poor oral health. Quality measures may focus on the prevention of tooth loss and the management of oral health conditions, emphasizing the importance of early intervention and comprehensive dental care.

ICD-9 vs ICD-10

The clinical significance of K08.404 lies in its potential to affect a patient's quality of life, including difficulties in eating and speaking, which can lead to nutritional deficiencies and social withdrawal. Population health impacts include increased healthcare utilization for dental care and potential systemic health issues related to poor oral health. Quality measures may focus on the prevention of tooth loss and the management of oral health conditions, emphasizing the importance of early intervention and comprehensive dental care.

Reimbursement & Billing Impact

reimbursement. Regular audits of coding practices can help mitigate risks associated with billing for this condition.

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 K08.404?

K08.404 encompasses partial loss of teeth without a specified cause, which may include loss due to unknown factors, non-traumatic conditions, or systemic diseases that have not been clearly identified.

When should K08.404 be used instead of related codes?

K08.404 should be used when the cause of tooth loss is not clearly defined, whereas related codes should be selected when specific etiologies such as trauma or periodontal disease are documented.

What documentation supports K08.404?

Documentation should include a comprehensive dental examination report, imaging studies (e.g., X-rays), and a detailed patient history that outlines the circumstances surrounding the tooth loss.