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ICD-10 Guide
ICD-10 CodesK08.423

K08.423

Billable

Partial loss of teeth due to periodontal diseases, class III

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

Code Description

ICD-10 K08.423 is a billable code used to indicate a diagnosis of partial loss of teeth due to periodontal diseases, class iii.

Key Diagnostic Point:

K08.423 refers to partial loss of teeth due to periodontal diseases, class III, which is characterized by significant attachment loss and periodontal pocket formation. Clinically, patients may present with mobility of teeth, gingival recession, and potential tooth loss. The anatomy involved primarily includes the periodontium, which encompasses the gums, periodontal ligament, and alveolar bone. Disease progression typically begins with gingivitis, advancing to periodontitis if untreated. In class III periodontal disease, the loss of periodontal support is substantial, leading to increased tooth mobility and potential loss of teeth. Diagnostic considerations include clinical examination, probing depths, radiographic evaluation, and assessment of attachment loss. Accurate diagnosis is crucial for effective management and treatment planning, which may involve scaling and root planing, surgical interventions, and ongoing periodontal maintenance.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough clinical evaluation and understanding of periodontal disease stages.
  • Treatment complexity: Involves multi-disciplinary approaches including periodontics and restorative dentistry.
  • Documentation requirements: Detailed records of clinical findings, treatment plans, and patient history are essential.
  • Coding specificity: Requires precise coding to differentiate between various classes of periodontal disease.

Audit Risk Factors

  • Common coding errors: Misclassification of periodontal disease severity can lead to incorrect coding.
  • Documentation gaps: Incomplete records may result in denials or audits.
  • Billing challenges: Complexity of treatment may lead to discrepancies in reimbursement if not properly documented.

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: Periodontics

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 K08.423 lies in its association with systemic health issues, as periodontal disease has been linked to conditions such as diabetes and cardiovascular disease. The population health impact is substantial, given the prevalence of periodontal diseases and their contribution to tooth loss in adults. Quality measures focus on improving periodontal health through preventive care and early intervention, which can reduce healthcare utilization patterns related to dental emergencies and restorative procedures.

ICD-9 vs ICD-10

The clinical significance of K08.423 lies in its association with systemic health issues, as periodontal disease has been linked to conditions such as diabetes and cardiovascular disease. The population health impact is substantial, given the prevalence of periodontal diseases and their contribution to tooth loss in adults. Quality measures focus on improving periodontal health through preventive care and early intervention, which can reduce healthcare utilization patterns related to dental emergencies and restorative procedures.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of periodontal treatment, which may involve multiple visits and procedures. Common denials may arise from insufficient documentation or misclassification of the periodontal disease stage. Best practices include ensuring that all clinical findings are well-documented, treatment plans are clearly outlined, and that the coding accurately reflects the severity of the condition to avoid billing discrepancies.

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 K08.423?

K08.423 covers partial loss of teeth specifically due to class III periodontal diseases, which includes significant attachment loss and periodontal pocket formation. It is essential to document the extent of periodontal disease and any associated symptoms.

When should K08.423 be used instead of related codes?

K08.423 should be used when there is clear evidence of class III periodontal disease, characterized by significant attachment loss and mobility of teeth. It is crucial to differentiate it from class I and II to ensure appropriate treatment and reimbursement.

What documentation supports K08.423?

Documentation for K08.423 should include clinical examination findings, periodontal charting, radiographic evidence of bone loss, and treatment plans. Detailed notes on patient history and response to previous treatments are also necessary.