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ICD-10 Guide
ICD-10 CodesK06.020

K06.020

Billable

Generalized gingival recession, unspecified

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

Code Description

ICD-10 K06.020 is a billable code used to indicate a diagnosis of generalized gingival recession, unspecified.

Key Diagnostic Point:

Generalized gingival recession, unspecified, refers to the condition where the gum tissue surrounding the teeth recedes, exposing the roots of the teeth. This condition can lead to increased tooth sensitivity, aesthetic concerns, and potential periodontal disease. The anatomy involved includes the gingiva (gums), which are critical for supporting the teeth and maintaining oral health. Disease progression may vary; it can be influenced by factors such as periodontal disease, aggressive tooth brushing, tobacco use, and genetic predisposition. Clinically, patients may present with visible gum recession, sensitivity to hot or cold stimuli, and in severe cases, tooth mobility. Diagnostic considerations include a thorough clinical examination, periodontal probing, and radiographic evaluation to assess the extent of recession and any underlying bone loss. Treatment options may range from conservative approaches, such as improved oral hygiene and desensitizing agents, to surgical interventions like gum grafting, depending on the severity and cause of the recession.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough examination and understanding of periodontal health.
  • Treatment complexity: May involve both non-surgical and surgical interventions.
  • Documentation requirements: Detailed clinical notes and treatment plans are necessary.
  • Coding specificity: Requires accurate coding to differentiate from other gingival conditions.

Audit Risk Factors

  • Common coding errors: Misuse of related codes or failure to document the extent of recession.
  • Documentation gaps: Incomplete clinical notes that do not support the diagnosis.
  • Billing challenges: Potential denials due to lack of specificity or inadequate documentation.

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

Periodontology

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

Generalized gingival recession can significantly impact oral health, leading to increased sensitivity, aesthetic concerns, and potential tooth loss if untreated. It is prevalent in various populations, particularly among older adults and those with poor oral hygiene practices. Understanding the epidemiology of this condition can inform preventive measures and improve patient outcomes. Quality measures may include monitoring the incidence of gingival recession and the effectiveness of treatment interventions in reducing its prevalence.

ICD-9 vs ICD-10

Generalized gingival recession can significantly impact oral health, leading to increased sensitivity, aesthetic concerns, and potential tooth loss if untreated. It is prevalent in various populations, particularly among older adults and those with poor oral hygiene practices. Understanding the epidemiology of this condition can inform preventive measures and improve patient outcomes. Quality measures may include monitoring the incidence of gingival recession and the effectiveness of treatment interventions in reducing its prevalence.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the payer's policies regarding periodontal treatments. Common denials may arise from insufficient documentation or lack of specificity in coding. Best practices include using precise codes, maintaining thorough clinical records, and ensuring that treatment rationale is clearly articulated in the documentation.

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 K06.020?

K06.020 covers generalized gingival recession without specifying the cause. It may include cases related to periodontal disease, mechanical trauma, or other factors leading to gum tissue loss.

When should K06.020 be used instead of related codes?

K06.020 should be used when the gingival recession is generalized and the specific cause is not identified. If the recession is localized or associated with specific conditions, related codes should be considered.

What documentation supports K06.020?

Documentation should include a comprehensive periodontal examination, clinical findings of recession, treatment plans, and any relevant patient history that may contribute to the condition.