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ICD-10 Guide
ICD-10 CodesK06.0

K06.0

Non-billable

Gingival recession

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

Code Description

ICD-10 K06.0 is a used to indicate a diagnosis of gingival recession.

Key Diagnostic Point:

Gingival recession, classified under K06.0, refers to the apical migration of the gingival margin, leading to exposure of the root surface of the teeth. Clinically, it presents as a visible loss of gum tissue, which can result in sensitivity, aesthetic concerns, and increased risk of root caries. The anatomy involved includes the gingiva, periodontal ligament, and alveolar bone. Disease progression can be influenced by factors such as periodontal disease, mechanical trauma from brushing, and anatomical predispositions. Diagnosis typically involves clinical examination, probing depth measurements, and radiographic evaluation to assess the extent of periodontal involvement. It is crucial to differentiate gingival recession from other periodontal conditions, as treatment approaches may vary significantly based on the underlying cause and severity of the recession.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough clinical evaluation and potential imaging.
  • Treatment complexity: May involve non-surgical and surgical interventions depending on severity.
  • Documentation requirements: Detailed records of clinical findings and treatment plans are essential.
  • Coding specificity: Requires accurate coding to distinguish from other periodontal diseases.

Audit Risk Factors

  • Common coding errors: Misclassification with other periodontal diseases.
  • Documentation gaps: Incomplete records of clinical findings and treatment rationale.
  • Billing challenges: Potential denials if documentation does not 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: Periodontics

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

Gingival recession has significant clinical implications, affecting not only oral health but also overall quality of life. It can lead to increased dental sensitivity and aesthetic concerns, impacting patient satisfaction and treatment compliance. Population health studies indicate that periodontal diseases, including gingival recession, are prevalent, necessitating effective management strategies. Quality measures related to periodontal health are increasingly important in healthcare utilization patterns, emphasizing the need for preventive care and early intervention.

ICD-9 vs ICD-10

Gingival recession has significant clinical implications, affecting not only oral health but also overall quality of life. It can lead to increased dental sensitivity and aesthetic concerns, impacting patient satisfaction and treatment compliance. Population health studies indicate that periodontal diseases, including gingival recession, are prevalent, necessitating effective management strategies. Quality measures related to periodontal health are increasingly important in healthcare utilization patterns, emphasizing the need for preventive care and early intervention.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed and the necessity of the treatment. Common denials may arise from insufficient documentation or incorrect coding. Best practices include ensuring that all clinical notes are complete and that the rationale for treatment is clearly articulated. Additionally, coders should verify that the services billed align with the diagnosis to avoid discrepancies.

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 K06.0?

K06.0 specifically covers gingival recession without associated periodontal disease. It is important to note that this code does not encompass other forms of gingival disease or conditions that may involve inflammation or infection.

When should K06.0 be used instead of related codes?

K06.0 should be used when there is clear evidence of gingival recession without the presence of other periodontal diseases. If there are signs of inflammation or other periodontal issues, codes such as K05.0 may be more appropriate.

What documentation supports K06.0?

Documentation should include clinical examination findings, probing depths, photographs of the recession, and any treatment plans. Detailed notes on the patient's history and risk factors for gingival recession are also essential.