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ICD-10 Guide
ICD-10 CodesK08.42

K08.42

Non-billable

Partial loss of teeth due to periodontal diseases

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

Code Description

ICD-10 K08.42 is a used to indicate a diagnosis of partial loss of teeth due to periodontal diseases.

Key Diagnostic Point:

K08.42 refers to partial loss of teeth due to periodontal diseases, a condition that arises from the inflammatory processes affecting the supporting structures of the teeth, including the gums, periodontal ligament, and alveolar bone. Clinically, patients may present with gum recession, tooth mobility, and eventual tooth loss if the disease progresses unchecked. The anatomy involved primarily includes the gingiva, periodontal ligaments, and the alveolar bone, which are critical for maintaining tooth stability. Periodontal disease typically progresses through stages, beginning with gingivitis, which is reversible, and advancing to periodontitis, which can lead to irreversible damage and tooth loss. Diagnostic considerations include clinical examinations, radiographic assessments, and periodontal probing to evaluate the extent of attachment loss and pocket depth. Early detection and intervention are crucial to prevent further deterioration and maintain oral health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough clinical evaluation and understanding of periodontal disease progression.
  • Treatment complexity: Involves multi-disciplinary approaches including dental hygiene, surgical interventions, and possibly systemic treatments.
  • Documentation requirements: Detailed records of clinical findings, treatment plans, and patient compliance are necessary.
  • Coding specificity: Requires accurate coding to differentiate from other dental conditions.

Audit Risk Factors

  • Common coding errors: Misclassification of periodontal disease severity or incorrect coding of tooth loss.
  • Documentation gaps: Incomplete records of periodontal assessments or treatment plans.
  • Billing challenges: Potential denials due to lack of supporting documentation for the severity of periodontal disease.

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

Periodontology

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 K08.42 lies in its association with systemic health, as periodontal disease has been linked to conditions such as diabetes and cardiovascular disease. The population health impact is substantial, as periodontal disease affects a significant portion of adults, leading to increased healthcare utilization for dental and related medical services. Quality measures related to oral health are increasingly recognized in healthcare systems, emphasizing the need for effective management of periodontal diseases to improve overall health outcomes.

ICD-9 vs ICD-10

The clinical significance of K08.42 lies in its association with systemic health, as periodontal disease has been linked to conditions such as diabetes and cardiovascular disease. The population health impact is substantial, as periodontal disease affects a significant portion of adults, leading to increased healthcare utilization for dental and related medical services. Quality measures related to oral health are increasingly recognized in healthcare systems, emphasizing the need for effective management of periodontal diseases to improve overall health outcomes.

Reimbursement & Billing Impact

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 K08.42?

K08.42 covers partial loss of teeth specifically due to periodontal diseases, including chronic periodontitis and aggressive periodontitis, where the loss of attachment and bone support leads to tooth mobility and loss.

When should K08.42 be used instead of related codes?

K08.42 should be used when there is clear evidence of tooth loss attributable to periodontal disease, as opposed to other causes of tooth loss such as trauma or caries, which would require different codes.

What documentation supports K08.42?

Documentation should include periodontal charting, radiographic evidence of bone loss, treatment history, and any relevant clinical findings that support the diagnosis of periodontal disease leading to tooth loss.