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ICD-10 Guide
ICD-10 CodesK08.11

K08.11

Non-billable

Complete loss of teeth due to trauma

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

Code Description

ICD-10 K08.11 is a used to indicate a diagnosis of complete loss of teeth due to trauma.

Key Diagnostic Point:

K08.11 refers to complete loss of teeth due to trauma, which can significantly impact a patient's oral health and overall well-being. Clinically, this condition presents as the absence of all teeth in one or both dental arches, often resulting from accidents, falls, or other forms of physical trauma. The anatomy involved includes the maxilla and mandible, as well as the periodontal structures that support the teeth. Disease progression can vary; immediate loss of teeth may lead to complications such as malocclusion, difficulty in mastication, and alterations in speech. Additionally, the absence of teeth can lead to bone resorption in the jaw, further complicating future dental rehabilitation. Diagnostic considerations include a thorough clinical examination, radiographic imaging to assess bone integrity, and a review of the patient's medical history to identify any underlying conditions that may affect healing or treatment. Proper diagnosis is essential for planning appropriate restorative procedures, such as dentures or implants, to restore function and aesthetics.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misclassification of the extent of tooth loss.
  • Documentation gaps may arise if the cause of trauma is not clearly stated.
  • Billing challenges can occur if the treatment plan is not adequately documented.

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 K08.11 extends beyond dental health, as complete tooth loss can affect nutrition, speech, and psychosocial well-being. Population health impact includes increased healthcare utilization for dental rehabilitation and potential complications related to malnutrition. Quality measures may focus on timely restoration of function and patient satisfaction with dental care. Epidemiologically, the incidence of traumatic tooth loss can vary based on age, activity level, and access to preventive dental care.

ICD-9 vs ICD-10

The clinical significance of K08.11 extends beyond dental health, as complete tooth loss can affect nutrition, speech, and psychosocial well-being. Population health impact includes increased healthcare utilization for dental rehabilitation and potential complications related to malnutrition. Quality measures may focus on timely restoration of function and patient satisfaction with dental care. Epidemiologically, the incidence of traumatic tooth loss can vary based on age, activity level, and access to preventive dental care.

Reimbursement & Billing Impact

Reimbursement considerations include verifying that the procedure codes used align with the diagnosis. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for restorative procedures. Coding best practices recommend maintaining detailed records of the trauma incident, treatment plans, and follow-up care to support claims and reduce the risk of audits.

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 K08.11?

K08.11 specifically covers the complete loss of teeth due to trauma, which may include avulsion of teeth from accidents or injuries. It does not cover loss due to periodontal disease or other non-traumatic causes.

When should K08.11 be used instead of related codes?

K08.11 should be used when there is a complete loss of teeth due to a traumatic event. If the loss is partial or due to other causes, such as disease, other codes like K08.12 or K05.1 should be considered.

What documentation supports K08.11?

Documentation should include a detailed account of the trauma incident, clinical examination findings, radiographic evidence of tooth loss, and any treatment plans proposed for restoration.