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ICD-10 Guide
ICD-10 CodesK08.414

K08.414

Billable

Partial loss of teeth due to trauma, class IV

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

Code Description

ICD-10 K08.414 is a billable code used to indicate a diagnosis of partial loss of teeth due to trauma, class iv.

Key Diagnostic Point:

K08.414 refers to partial loss of teeth due to trauma, classified as class IV. This condition typically arises from significant external forces that lead to the fracture or avulsion of teeth, impacting the oral cavity's anatomy and function. Clinically, patients may present with pain, swelling, and difficulty in chewing or speaking, which can lead to nutritional deficiencies if not addressed. The affected teeth may exhibit mobility, and there could be associated soft tissue injuries. The disease progression can vary; if left untreated, it may lead to further dental complications, including infection or misalignment of remaining teeth. Diagnostic considerations include a thorough clinical examination, radiographic imaging to assess the extent of damage, and possibly referral to a dental specialist for comprehensive evaluation. Treatment may involve restorative procedures, such as crowns or bridges, and in severe cases, extraction may be necessary. Proper documentation of the trauma's nature, the extent of tooth loss, and the treatment plan is essential for accurate coding and reimbursement.

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 cause of tooth loss.
  • Documentation gaps may arise if the trauma's specifics are not clearly outlined.
  • Billing challenges can occur if the treatment plan is not well-documented or if the relationship between the trauma and tooth loss is unclear.

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 K08.414 lies in its potential to affect a patient's quality of life, impacting their ability to eat, speak, and maintain oral hygiene. Population health impact includes the need for increased dental care resources for trauma-related injuries. Quality measures may focus on timely intervention and restoration of function. Healthcare utilization patterns may reflect a higher incidence of emergency dental visits following traumatic events, highlighting the importance of preventive measures in at-risk populations.

ICD-9 vs ICD-10

The clinical significance of K08.414 lies in its potential to affect a patient's quality of life, impacting their ability to eat, speak, and maintain oral hygiene. Population health impact includes the need for increased dental care resources for trauma-related injuries. Quality measures may focus on timely intervention and restoration of function. Healthcare utilization patterns may reflect a higher incidence of emergency dental visits following traumatic events, highlighting the importance of preventive measures in at-risk populations.

Reimbursement & Billing Impact

Reimbursement considerations include the need for pre-authorization for certain treatments and ensuring that the documentation supports the medical necessity of the procedures. Common denials may arise from insufficient documentation or failure to link the diagnosis with the treatment provided. Best practices include maintaining thorough records of the patient's history, the nature of the trauma, and the treatment plan, as well as ensuring that all claims are submitted with the correct codes and modifiers as needed.

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 K08.414?

K08.414 covers cases of partial tooth loss specifically due to traumatic events such as accidents, falls, or sports injuries. It does not include tooth loss due to decay or periodontal disease.

When should K08.414 be used instead of related codes?

K08.414 should be used when the loss of teeth is directly attributable to trauma. If the loss is due to non-traumatic causes, such as caries or periodontal disease, other codes should be selected.

What documentation supports K08.414?

Documentation should include a detailed account of the trauma, clinical findings, imaging results, and the treatment plan. Notes should clearly indicate the relationship between the trauma and the tooth loss.