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ICD-10 Guide
ICD-10 CodesK06.2

K06.2

Billable

Gingival and edentulous alveolar ridge lesions associated with trauma

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

Code Description

ICD-10 K06.2 is a billable code used to indicate a diagnosis of gingival and edentulous alveolar ridge lesions associated with trauma.

Key Diagnostic Point:

K06.2 refers to gingival and edentulous alveolar ridge lesions associated with trauma. These lesions can manifest as localized swelling, ulceration, or necrosis of the gingival tissue and surrounding structures, often resulting from physical injury, such as lacerations or abrasions due to dental procedures, ill-fitting dentures, or accidental trauma. The anatomy involved primarily includes the gingiva, which is the soft tissue that surrounds and supports the teeth, and the edentulous alveolar ridge, which is the bony ridge that holds the teeth in place. Disease progression can vary, with some lesions resolving spontaneously while others may lead to chronic inflammation or infection if not properly managed. Diagnostic considerations include a thorough clinical examination, patient history to ascertain the cause of trauma, and possibly imaging studies to evaluate the extent of the injury. Differential diagnoses may include other gingival diseases, infections, or neoplastic processes, necessitating careful evaluation to ensure appropriate treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of trauma-related lesions and their differentiation from other conditions.
  • Treatment complexity: Management may involve surgical intervention, wound care, or referral to specialists.
  • Documentation requirements: Detailed documentation of the trauma mechanism and clinical findings is essential.
  • Coding specificity: Requires precise coding to differentiate from other gingival conditions.

Audit Risk Factors

  • Common coding errors: Misidentifying the cause of lesions or using incorrect codes for related conditions.
  • Documentation gaps: Incomplete records regarding the nature of the trauma or treatment provided.
  • Billing challenges: Potential denials if documentation does not clearly support the diagnosis and treatment.

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 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 K06.2 lies in its potential to affect oral health and overall quality of life. Traumatic lesions can lead to pain, difficulty in eating, and increased risk of infection. Understanding the epidemiology of such injuries can inform preventive measures in dental practices and community health initiatives, ultimately improving patient outcomes and reducing healthcare utilization.

ICD-9 vs ICD-10

The clinical significance of K06.2 lies in its potential to affect oral health and overall quality of life. Traumatic lesions can lead to pain, difficulty in eating, and increased risk of infection. Understanding the epidemiology of such injuries can inform preventive measures in dental practices and community health initiatives, ultimately improving patient outcomes and reducing healthcare utilization.

Reimbursement & Billing Impact

impact on the patient's oral health. Reimbursement considerations include ensuring that the diagnosis is clearly linked to the treatment provided. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include maintaining thorough records of patient interactions, treatment plans, and follow-up assessments, as well as using appropriate modifiers to indicate the nature of the trauma when applicable.

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 K06.2?

K06.2 covers lesions of the gingiva and edentulous alveolar ridge that arise specifically due to trauma. This includes abrasions, lacerations, and other injuries that affect the soft tissue and underlying bone, leading to inflammation or ulceration.

When should K06.2 be used instead of related codes?

K06.2 should be used when the lesions are directly attributable to trauma. If the lesions are due to non-traumatic causes, such as infections or systemic diseases, other codes should be considered, such as K05 for gingivitis or K06.1 for other gingival lesions.

What documentation supports K06.2?

Documentation should include a detailed account of the trauma mechanism, clinical findings such as lesion size and appearance, treatment provided, and follow-up care. Photographic evidence and imaging studies may also support the diagnosis.