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 CodesK01.1

K01.1

Billable

Impacted teeth

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

Code Description

ICD-10 K01.1 is a billable code used to indicate a diagnosis of impacted teeth.

Key Diagnostic Point:

Impacted teeth refer to teeth that are unable to erupt properly into the dental arch due to obstruction by other teeth or anatomical structures. This condition is most commonly seen with third molars (wisdom teeth) but can occur with any tooth. Clinically, impacted teeth may present with pain, swelling, or infection, particularly if they are partially erupted, leading to pericoronitis. The anatomy involved includes the maxilla and mandible, where the teeth are situated. Disease progression can lead to complications such as cyst formation, damage to adjacent teeth, and periodontal disease. Diagnostic considerations include clinical examination, radiographic imaging (such as panoramic X-rays), and assessment of symptoms. Treatment often involves surgical extraction, especially if the impacted tooth is symptomatic or poses a risk of complications. Regular dental evaluations are crucial for early identification and management of impacted teeth.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical evaluation to confirm diagnosis.
  • Treatment complexity: Surgical intervention may be necessary, which involves risks and recovery considerations.
  • Documentation requirements: Detailed documentation of symptoms, imaging results, and treatment plans is essential.
  • Coding specificity: Requires accurate coding to differentiate between types of impaction and associated complications.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of impaction or failure to document the reason for extraction.
  • Documentation gaps: Incomplete records regarding symptoms or imaging results can lead to denials.
  • Billing challenges: Variability in insurance coverage for surgical procedures can complicate billing.

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 impacted teeth is notable, as they can lead to pain, infection, and other dental complications if left untreated. Population health impact includes increased dental visits and potential surgical interventions, which can strain healthcare resources. Quality measures focus on timely diagnosis and treatment to prevent complications, while epidemiological studies indicate a prevalence of impacted teeth in certain demographics, particularly young adults.

ICD-9 vs ICD-10

The clinical significance of impacted teeth is notable, as they can lead to pain, infection, and other dental complications if left untreated. Population health impact includes increased dental visits and potential surgical interventions, which can strain healthcare resources. Quality measures focus on timely diagnosis and treatment to prevent complications, while epidemiological studies indicate a prevalence of impacted teeth in certain demographics, particularly young adults.

Reimbursement & Billing Impact

impacted teeth often involves surgical extraction codes and may require pre-authorization from insurance providers. Documentation must clearly outline the necessity of the procedure, including the patient's symptoms and the potential for complications. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include thorough clinical notes, imaging reports, and clear communication with insurance companies to ensure proper 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 K01.1?

K01.1 specifically covers impacted teeth that are obstructed from proper eruption. This includes third molars and other teeth that may be impacted due to crowding, anatomical anomalies, or other dental conditions.

When should K01.1 be used instead of related codes?

K01.1 should be used when there is clear evidence of impacted teeth that require intervention. It is important to differentiate from K01.0 when the specific type of impaction is known and documented.

What documentation supports K01.1?

Documentation should include clinical findings, patient symptoms, imaging results (like X-rays), and treatment plans. Detailed notes on the rationale for surgical intervention are also necessary.