ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesK09.1

K09.1

Billable

Developmental (nonodontogenic) cysts of oral region

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

Code Description

ICD-10 K09.1 is a billable code used to indicate a diagnosis of developmental (nonodontogenic) cysts of oral region.

Key Diagnostic Point:

Developmental (nonodontogenic) cysts of the oral region are benign lesions that arise from the remnants of embryonic tissues. These cysts are typically located in the jaw or surrounding oral structures and can vary in size and presentation. Clinically, patients may present with asymptomatic swelling or discomfort in the oral cavity, which may lead to incidental discovery during dental examinations. The most common types of nonodontogenic cysts include nasopalatine duct cysts, median palatine cysts, and globulomaxillary cysts. The anatomy involved primarily includes the maxilla and mandible, as well as adjacent soft tissues. Disease progression is generally slow, and while these cysts are benign, they can cause displacement of teeth or resorption of adjacent bone if left untreated. Diagnostic considerations include imaging studies such as panoramic radiographs or CT scans, which help in visualizing the cyst's size, location, and relationship with surrounding structures. A definitive diagnosis is often confirmed through histopathological examination following surgical excision.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as imaging and histological confirmation are required.
  • Treatment complexity: Moderate, typically involves surgical intervention.
  • Documentation requirements: Requires detailed clinical notes and imaging reports.
  • Coding specificity: Specific to nonodontogenic cysts, necessitating accurate coding.

Audit Risk Factors

  • Common coding errors: Misclassification of odontogenic vs. nonodontogenic cysts.
  • Documentation gaps: Incomplete clinical notes or lack of imaging documentation.
  • Billing challenges: Potential denials due to insufficient evidence of medical necessity for surgical intervention.

Specialty Focus

Medical Specialties

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

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

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Developmental nonodontogenic cysts, while benign, can significantly impact oral health if not diagnosed and treated appropriately. Their prevalence in the population underscores the importance of early detection and management to prevent complications such as infection or bone resorption. Quality measures in dental care often include the timely identification of these lesions, influencing healthcare utilization patterns and overall patient outcomes.

ICD-9 vs ICD-10

Developmental nonodontogenic cysts, while benign, can significantly impact oral health if not diagnosed and treated appropriately. Their prevalence in the population underscores the importance of early detection and management to prevent complications such as infection or bone resorption. Quality measures in dental care often include the timely identification of these lesions, influencing healthcare utilization patterns and overall patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include verifying coverage for excisional biopsy or cyst removal procedures. Common denials may arise from insufficient documentation or failure to demonstrate the cyst's impact on oral health. Best practices include maintaining thorough clinical notes, imaging reports, and ensuring that the procedure codes align with the diagnosis to minimize billing challenges.

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 K09.1?

K09.1 covers developmental nonodontogenic cysts such as nasopalatine duct cysts, median palatine cysts, and globulomaxillary cysts, which are characterized by their origin from embryonic remnants rather than tooth development.

When should K09.1 be used instead of related codes?

K09.1 should be used when the cyst is confirmed as nonodontogenic, particularly when imaging and histological evidence support this diagnosis, differentiating it from odontogenic cysts coded under K09.0.

What documentation supports K09.1?

Documentation should include clinical findings, imaging studies (e.g., X-rays, CT scans), and histopathological reports confirming the diagnosis of a nonodontogenic cyst.