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ICD-10 Guide
ICD-10 CodesChapter 11: Diseases of the digestive systemK01

K01

Non-billable

Embedded and impacted teeth

Chapter 11:Diseases of the digestive system

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

Code Description

ICD-10 K01 is a used to indicate a diagnosis of embedded and impacted teeth.

Key Diagnostic Point:

K01 refers to embedded and impacted teeth, primarily affecting the oral cavity rather than the digestive system directly. However, the presence of impacted teeth can lead to secondary gastrointestinal issues due to pain, infection, or difficulty in mastication, which may affect dietary habits and overall nutrition. Clinically, impacted teeth are often asymptomatic but can present with symptoms such as swelling, pain, or infection if they cause pressure on adjacent teeth or tissues. The anatomy involved includes the maxilla and mandible, where teeth may become trapped due to lack of space or abnormal positioning. Disease progression can lead to complications such as pericoronitis, cyst formation, or damage to adjacent teeth. Diagnostic considerations include clinical examination, radiographic imaging (such as panoramic X-rays), and assessment of symptoms. Early identification and management are crucial to prevent further complications that may indirectly affect gastrointestinal health due to altered eating patterns.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical evaluation to confirm
  • Treatment complexity: May involve surgical extraction or orthodontic intervention
  • Documentation requirements: Detailed clinical notes and imaging reports needed
  • Coding specificity: Requires precise coding based on the type and location of impaction

Audit Risk Factors

  • Common coding errors: Misidentifying the type of impaction or failing to document symptoms
  • Documentation gaps: Lack of imaging or clinical rationale for the procedure
  • Billing challenges: Denials due to insufficient documentation or incorrect procedure codes

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 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 K01 lies in its potential to cause pain and complications that can affect a patient's quality of life and nutritional intake. Population health impact includes the prevalence of impacted teeth, which can lead to increased healthcare utilization for dental and surgical interventions. Quality measures may focus on timely diagnosis and treatment of impacted teeth to prevent further complications. Epidemiologically, impacted teeth are common in adolescents and young adults, making awareness and management crucial for maintaining oral and overall health.

ICD-9 vs ICD-10

The clinical significance of K01 lies in its potential to cause pain and complications that can affect a patient's quality of life and nutritional intake. Population health impact includes the prevalence of impacted teeth, which can lead to increased healthcare utilization for dental and surgical interventions. Quality measures may focus on timely diagnosis and treatment of impacted teeth to prevent further complications. Epidemiologically, impacted teeth are common in adolescents and young adults, making awareness and management crucial for maintaining oral and overall health.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the extraction and any associated procedures. Common denials may arise from inadequate documentation or failure to demonstrate medical necessity. Coders should ensure that all related services are accurately captured and that the documentation supports the diagnosis and treatment provided. Best practices include thorough clinical notes and timely submission of claims to avoid delays in payment.

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 K01?

K01 covers conditions related to embedded and impacted teeth, including those that are partially erupted or completely unerupted, and may lead to complications such as infection or damage to adjacent teeth.

When should K01 be used instead of related codes?

K01 should be used when there is clear evidence of impacted teeth that require intervention, differentiating it from codes for non-impacted or fully erupted teeth.

What documentation supports K01?

Documentation should include clinical findings, imaging studies (like X-rays), treatment plans, and any symptoms related to the impacted teeth to support the use of K01.