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ICD-10 Guide
ICD-10 CodesK08.49

K08.49

Non-billable

Partial loss of teeth due to other specified cause

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

Code Description

ICD-10 K08.49 is a used to indicate a diagnosis of partial loss of teeth due to other specified cause.

Key Diagnostic Point:

K08.49 refers to partial loss of teeth due to other specified causes, which can include a variety of conditions that lead to tooth loss not classified elsewhere. Clinically, this may present as missing teeth due to trauma, periodontal disease, or other systemic conditions affecting oral health. The anatomy involved primarily includes the dental structures such as enamel, dentin, pulp, and supporting periodontal tissues. Disease progression can vary; for instance, periodontal disease may lead to gradual tooth loss, while trauma can result in sudden loss. Diagnostic considerations involve a thorough dental examination, radiographic imaging, and possibly laboratory tests to identify underlying systemic conditions. It is crucial to differentiate K08.49 from other codes related to tooth loss, such as those specifically related to periodontal disease or trauma, to ensure accurate coding and appropriate treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of various causes of tooth loss.
  • Treatment complexity: May involve multidisciplinary approaches including dentistry and potentially other specialties.
  • Documentation requirements: Detailed clinical notes and imaging may be necessary.
  • Coding specificity: Requires precise identification of the cause of tooth loss.

Audit Risk Factors

  • Common coding errors: Misclassification of tooth loss causes.
  • Documentation gaps: Incomplete records regarding the cause of tooth loss.
  • Billing challenges: Potential for denials if documentation does not clearly support the diagnosis.

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K08.49 lies in its association with various underlying health conditions that can affect oral health and overall well-being. Understanding the causes of partial tooth loss can lead to better management strategies and improved patient outcomes. Population health impact includes the need for preventive measures and education on oral hygiene, particularly in populations at risk for systemic diseases that may contribute to tooth loss. Quality measures may focus on the prevention of tooth loss and the management of associated conditions, influencing healthcare utilization patterns.

ICD-9 vs ICD-10

The clinical significance of K08.49 lies in its association with various underlying health conditions that can affect oral health and overall well-being. Understanding the causes of partial tooth loss can lead to better management strategies and improved patient outcomes. Population health impact includes the need for preventive measures and education on oral hygiene, particularly in populations at risk for systemic diseases that may contribute to tooth loss. Quality measures may focus on the prevention of tooth loss and the management of associated conditions, influencing healthcare utilization patterns.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is supported by clinical evidence and that the treatment aligns with the documented condition. Common denials may arise from insufficient documentation or failure to link the diagnosis with the procedure performed. Best practices include thorough clinical notes, accurate coding, and timely submission of claims to avoid delays in 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 K08.49?

K08.49 covers partial loss of teeth due to conditions such as trauma, systemic diseases (e.g., diabetes), or other specified causes that do not fall under more specific codes. It is essential to document the underlying cause to support the use of this code.

When should K08.49 be used instead of related codes?

K08.49 should be used when the partial loss of teeth is due to causes that are not classified under other specific codes, such as K08.40 for complete loss or K05.1 for periodontal disease. Proper documentation of the cause is crucial for accurate coding.

What documentation supports K08.49?

Documentation should include clinical notes detailing the patient's dental history, examination findings, imaging results, and any relevant systemic conditions that may contribute to tooth loss. This comprehensive documentation is vital for justifying the use of K08.49.