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ICD-10 Guide
ICD-10 CodesK08.50

K08.50

Billable

Unsatisfactory restoration of tooth, unspecified

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

Code Description

ICD-10 K08.50 is a billable code used to indicate a diagnosis of unsatisfactory restoration of tooth, unspecified.

Key Diagnostic Point:

K08.50 refers to an unsatisfactory restoration of a tooth that is unspecified, indicating that the restoration has failed to meet the expected clinical outcomes. This can manifest as recurrent caries, fracture of the restoration, or failure of the material used in the restoration. The anatomy involved primarily includes the tooth structure, which may be compromised due to decay, trauma, or previous dental procedures. Disease progression can lead to further complications such as pulpitis or abscess formation if not addressed. Diagnostic considerations include clinical examination, radiographic evaluation, and patient history to determine the cause of the unsatisfactory restoration. It is crucial to differentiate this condition from other dental codes that may specify the type of restoration failure or the specific tooth involved, as this can influence treatment decisions and coding accuracy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

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 K08.50 lies in its potential to lead to further dental complications if not addressed promptly. Poorly restored teeth can affect overall oral health, leading to increased healthcare utilization due to additional treatments required. Understanding the epidemiology of dental restoration failures can help in developing quality measures aimed at improving dental care outcomes and reducing the incidence of such conditions in the population.

ICD-9 vs ICD-10

The clinical significance of K08.50 lies in its potential to lead to further dental complications if not addressed promptly. Poorly restored teeth can affect overall oral health, leading to increased healthcare utilization due to additional treatments required. Understanding the epidemiology of dental restoration failures can help in developing quality measures aimed at improving dental care outcomes and reducing the incidence of such conditions in the population.

Reimbursement & Billing Impact

The clinical significance of K08.50 lies in its potential to lead to further dental complications if not addressed promptly. Poorly restored teeth can affect overall oral health, leading to increased healthcare utilization due to additional treatments required. Understanding the epidemiology of dental restoration failures can help in developing quality measures aimed at improving dental care outcomes and reducing the incidence of such conditions in the population.

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 K08.50?

K08.50 encompasses conditions where a dental restoration is deemed unsatisfactory without specifying the type of restoration or the tooth involved. This can include issues like recurrent decay under a filling, a crown that has come loose, or a bridge that is failing.

When should K08.50 be used instead of related codes?

K08.50 should be used when the specific type of restoration failure is not known or documented. If the failure is related to a specific tooth or type of restoration, more specific codes like K08.51 or K08.52 should be used.

What documentation supports K08.50?

Documentation should include clinical notes detailing the patient's complaints, examination findings, radiographic evidence of restoration failure, and any treatment plans proposed or undertaken.