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ICD-10 Guide
ICD-10 CodesK08.413

K08.413

Billable

Partial loss of teeth due to trauma, class III

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

Code Description

ICD-10 K08.413 is a billable code used to indicate a diagnosis of partial loss of teeth due to trauma, class iii.

Key Diagnostic Point:

K08.413 refers to partial loss of teeth due to trauma, classified as class III. This condition typically arises from significant external forces impacting the oral cavity, leading to the loss of one or more teeth. The affected anatomical structures include the teeth, periodontal ligaments, and surrounding alveolar bone. Clinically, patients may present with pain, swelling, and difficulty in mastication, which can affect their nutritional intake and overall health. The disease progression can vary; in some cases, immediate dental intervention may be necessary to prevent further complications such as infection or misalignment of remaining teeth. Diagnostic considerations include a thorough clinical examination, radiographic imaging to assess the extent of damage, and a detailed patient history to determine the cause of trauma. Treatment often involves dental restoration, prosthetics, or orthodontic intervention to restore function and aesthetics. Understanding the implications of K08.413 is crucial for managing the patient's oral health and preventing further gastrointestinal complications related to impaired chewing and digestion.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough assessment of trauma and dental health.
  • Treatment complexity: May involve multiple specialties including dentistry and oral surgery.
  • Documentation requirements: Detailed records of trauma, treatment plans, and follow-up care are essential.
  • Coding specificity: Requires precise coding to differentiate from other dental trauma codes.

Audit Risk Factors

  • Common coding errors: Misclassification of the extent of tooth loss.
  • Documentation gaps: Incomplete records of trauma or treatment.
  • Billing challenges: Potential denials if documentation does not support the severity of the condition.

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K08.413 lies in its potential to affect a patient's ability to chew and digest food properly, which can lead to nutritional deficiencies and gastrointestinal issues. The population health impact is notable, as dental trauma can occur in various settings, including sports and accidents, necessitating preventive measures. Quality measures may include tracking the incidence of dental trauma and the effectiveness of treatment protocols. Understanding healthcare utilization patterns related to dental trauma can inform public health initiatives aimed at reducing such injuries.

ICD-9 vs ICD-10

The clinical significance of K08.413 lies in its potential to affect a patient's ability to chew and digest food properly, which can lead to nutritional deficiencies and gastrointestinal issues. The population health impact is notable, as dental trauma can occur in various settings, including sports and accidents, necessitating preventive measures. Quality measures may include tracking the incidence of dental trauma and the effectiveness of treatment protocols. Understanding healthcare utilization patterns related to dental trauma can inform public health initiatives aimed at reducing such injuries.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the treatment and the necessity for potential surgical interventions. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that all relevant clinical notes, imaging results, and treatment plans are included in the patient's record to support the claim and facilitate timely reimbursement.

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 K08.413?

K08.413 covers partial loss of teeth due to trauma classified as class III, which may include fractures, avulsions, or other significant injuries to the teeth and surrounding structures.

When should K08.413 be used instead of related codes?

K08.413 should be used when there is a documented partial loss of teeth specifically due to trauma, differentiating it from complete loss or other dental conditions.

What documentation supports K08.413?

Documentation should include clinical notes detailing the trauma event, radiographic evidence of tooth loss, treatment plans, and follow-up assessments to support the diagnosis.