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ICD-10 Guide
ICD-10 CodesK08.111

K08.111

Billable

Complete loss of teeth due to trauma, class I

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

Code Description

ICD-10 K08.111 is a billable code used to indicate a diagnosis of complete loss of teeth due to trauma, class i.

Key Diagnostic Point:

K08.111 refers to complete loss of teeth due to trauma, classified as class I. This condition typically arises from significant external forces, such as accidents or falls, leading to the avulsion or fracture of teeth. The clinical presentation may include immediate pain, swelling, and bleeding in the oral cavity, along with the visible absence of one or more teeth. The anatomy involved primarily includes the dental structures, including the enamel, dentin, pulp, and periodontal ligaments. Disease progression can vary; if not managed promptly, it may lead to complications such as infection, misalignment of remaining teeth, and alterations in the patient's bite. Diagnostic considerations include a thorough clinical examination, radiographic imaging to assess the extent of trauma, and evaluation of surrounding soft tissues. Treatment often involves dental restoration or prosthetic options, depending on the severity of tooth loss and the patient's overall oral health status.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires accurate assessment of trauma and its effects on dental structures.
  • Treatment complexity: Involves potential surgical interventions or prosthetic solutions.
  • Documentation requirements: Detailed records of trauma, treatment plans, and follow-up care are essential.
  • Coding specificity: Requires precise coding to differentiate from other dental conditions.

Audit Risk Factors

  • Common coding errors: Misclassification of the extent of tooth loss.
  • Documentation gaps: Incomplete records of the trauma incident or treatment provided.
  • Billing challenges: Issues with insurance reimbursement for dental procedures related to trauma.

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 K08.111 lies in its implications for oral health and overall quality of life. Complete loss of teeth can affect nutrition, speech, and self-esteem, leading to broader health issues. Population health impact includes increased healthcare utilization for dental restorations and potential complications from untreated trauma. Epidemiologically, understanding the prevalence of dental trauma can inform preventive measures and public health initiatives aimed at reducing such injuries.

ICD-9 vs ICD-10

The clinical significance of K08.111 lies in its implications for oral health and overall quality of life. Complete loss of teeth can affect nutrition, speech, and self-esteem, leading to broader health issues. Population health impact includes increased healthcare utilization for dental restorations and potential complications from untreated trauma. Epidemiologically, understanding the prevalence of dental trauma can inform preventive measures and public health initiatives aimed at reducing such injuries.

Reimbursement & Billing Impact

Reimbursement may vary based on the extent of dental procedures performed, such as extractions or prosthetic replacements. Common denials can occur if documentation does not clearly establish the cause of tooth loss or if the treatment is not adequately justified. Best practices include ensuring all clinical notes are thorough and that any imaging studies are included in the patient's record to support the claim.

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 K08.111?

K08.111 specifically covers cases of complete loss of teeth resulting from traumatic incidents. This includes avulsed teeth due to accidents, sports injuries, or falls, where the entire tooth structure is lost.

When should K08.111 be used instead of related codes?

K08.111 should be used when there is a complete loss of teeth due to trauma. If only partial loss or other dental conditions are present, related codes such as K08.112 should be considered.

What documentation supports K08.111?

Documentation should include a detailed account of the trauma incident, clinical findings, radiographic evidence, treatment plans, and any follow-up care provided to support the diagnosis of complete tooth loss.