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ICD-10 Guide
ICD-10 CodesK08.194

K08.194

Billable

Complete loss of teeth due to other specified cause, class IV

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

Code Description

ICD-10 K08.194 is a billable code used to indicate a diagnosis of complete loss of teeth due to other specified cause, class iv.

Key Diagnostic Point:

K08.194 refers to complete loss of teeth due to other specified causes, classified as class IV. This condition can arise from various factors including systemic diseases, trauma, or other underlying conditions that lead to the deterioration of dental health. The anatomy involved primarily includes the maxilla and mandible, where teeth are anchored. The disease progression often begins with periodontal disease or other oral health issues that, if untreated, can lead to tooth loss. Patients may present with symptoms such as pain, swelling, and difficulty in chewing, which can significantly impact their nutritional intake and overall health. Diagnostic considerations include a thorough dental examination, radiographic imaging, and assessment of the patient's medical history to identify any systemic conditions contributing to tooth loss. Understanding the underlying cause is crucial for effective management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation of dental and systemic health.
  • Treatment complexity: May involve multidisciplinary approaches including dental restoration, prosthodontics, and management of underlying conditions.
  • Documentation requirements: Detailed documentation of the cause of tooth loss and treatment plans is essential.
  • Coding specificity: Requires precise coding to differentiate from other types of tooth loss.

Audit Risk Factors

  • Common coding errors: Misclassification of the cause of tooth loss.
  • Documentation gaps: Incomplete patient history or lack of evidence for the specified cause.
  • Billing challenges: Potential denials if the underlying cause is not well-documented.

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: General medicine or endocrinology (if systemic disease is involved)

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K08.194 lies in its potential to affect a patient's nutritional status and overall health due to difficulties in mastication. Population health impact includes the increased prevalence of tooth loss in aging populations and those with systemic diseases, highlighting the need for preventive dental care. Quality measures may focus on improving oral health outcomes and reducing the incidence of tooth loss through early intervention and education. Understanding healthcare utilization patterns related to this condition can inform better resource allocation and patient management strategies.

ICD-9 vs ICD-10

The clinical significance of K08.194 lies in its potential to affect a patient's nutritional status and overall health due to difficulties in mastication. Population health impact includes the increased prevalence of tooth loss in aging populations and those with systemic diseases, highlighting the need for preventive dental care. Quality measures may focus on improving oral health outcomes and reducing the incidence of tooth loss through early intervention and education. Understanding healthcare utilization patterns related to this condition can inform better resource allocation and patient management strategies.

Reimbursement & Billing Impact

Reimbursement considerations include the need for clear evidence of the underlying cause of tooth loss. Common denials may arise if documentation does not adequately support the diagnosis or if the treatment plan is not aligned with the coding. Best practices include ensuring that all relevant clinical notes, imaging, and treatment plans are included in the patient's medical record to facilitate smooth billing processes.

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 K08.194?

K08.194 encompasses tooth loss due to various specified causes such as systemic diseases (e.g., diabetes, autoimmune disorders), trauma, or other dental conditions that do not fall under the more common classifications.

When should K08.194 be used instead of related codes?

K08.194 should be used when tooth loss is attributed to a specific cause that is not classified under other codes, ensuring that the underlying condition is documented and clearly defined.

What documentation supports K08.194?

Documentation should include a comprehensive dental examination, patient history detailing the cause of tooth loss, treatment plans, and any relevant imaging studies that support the diagnosis.