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ICD-10 Guide
ICD-10 CodesK08.139

K08.139

Billable

Complete loss of teeth due to caries, unspecified class

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

Code Description

ICD-10 K08.139 is a billable code used to indicate a diagnosis of complete loss of teeth due to caries, unspecified class.

Key Diagnostic Point:

K08.139 refers to complete loss of teeth due to caries, unspecified class. This condition primarily affects the oral cavity, where dental caries, or tooth decay, leads to the progressive destruction of tooth structure. The clinical presentation often includes significant tooth loss, which can impact a patient's ability to chew, speak, and maintain proper nutrition. The anatomy involved includes the dental structures such as enamel, dentin, and pulp, which are progressively compromised by the carious process. Disease progression typically starts with the demineralization of enamel, leading to cavities that can extend into deeper layers of the tooth, ultimately resulting in tooth loss if untreated. Diagnostic considerations for K08.139 include a thorough dental examination, radiographic imaging to assess the extent of caries, and patient history to evaluate risk factors such as dietary habits, oral hygiene practices, and previous dental treatments. This code is essential for capturing the impact of dental caries on overall health, particularly in relation to gastrointestinal conditions, as tooth loss can lead to difficulties in mastication and subsequent digestive issues.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive dental evaluation and imaging.
  • Treatment complexity: May involve restorative procedures or prosthetic solutions.
  • Documentation requirements: Detailed clinical notes and radiographic evidence are necessary.
  • Coding specificity: Requires precise coding to differentiate from other dental conditions.

Audit Risk Factors

  • Common coding errors: Misclassification of tooth loss due to other causes.
  • Documentation gaps: Incomplete patient history or lack of imaging documentation.
  • 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: Gastroenterology

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 K08.139 extends beyond dental health, as complete tooth loss can lead to nutritional deficiencies and gastrointestinal issues due to impaired chewing. Population health impact is notable, particularly in older adults, where tooth loss can affect quality of life and increase healthcare utilization for related conditions. Quality measures may include tracking the prevalence of tooth loss due to caries, emphasizing the importance of preventive dental care to mitigate the risk of tooth loss and associated health complications.

ICD-9 vs ICD-10

The clinical significance of K08.139 extends beyond dental health, as complete tooth loss can lead to nutritional deficiencies and gastrointestinal issues due to impaired chewing. Population health impact is notable, particularly in older adults, where tooth loss can affect quality of life and increase healthcare utilization for related conditions. Quality measures may include tracking the prevalence of tooth loss due to caries, emphasizing the importance of preventive dental care to mitigate the risk of tooth loss and associated health complications.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the payer, and common denials can occur if documentation does not clearly establish the link between caries and tooth loss. It is advisable to follow coding best practices, including using the most specific codes available and ensuring that all services rendered are appropriately documented and justified.

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 K08.139?

K08.139 covers complete loss of teeth specifically due to caries, without specifying the class of caries. It includes cases where multiple teeth are lost as a result of untreated dental decay.

When should K08.139 be used instead of related codes?

K08.139 should be used when the complete loss of teeth is directly attributed to caries, and no other underlying conditions such as periodontal disease are present. It is essential to differentiate based on the primary cause of tooth loss.

What documentation supports K08.139?

Documentation should include a comprehensive dental examination report, radiographic images showing the extent of caries, and a treatment plan outlining the management of tooth loss and any restorative procedures.