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ICD-10 Guide
ICD-10 CodesK08.419

K08.419

Billable

Partial loss of teeth due to trauma, unspecified class

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

Code Description

ICD-10 K08.419 is a billable code used to indicate a diagnosis of partial loss of teeth due to trauma, unspecified class.

Key Diagnostic Point:

K08.419 refers to partial loss of teeth due to trauma, unspecified class. This condition typically arises from physical injuries to the oral cavity, which can result in the loss of one or more teeth. The trauma may be caused by accidents, sports injuries, or falls, leading to complications that affect the integrity of the dental structure. The anatomy involved includes the teeth, gums, and surrounding oral tissues, which may also suffer from associated injuries. Clinically, patients may present with pain, swelling, and difficulty in chewing or speaking. Disease progression can vary; if not treated promptly, it may lead to further complications such as infections or misalignment of remaining teeth. Diagnostic considerations include a thorough clinical examination, radiographic imaging to assess the extent of damage, and possibly referral to dental specialists for comprehensive evaluation and management. Accurate diagnosis is crucial for effective treatment planning and to prevent long-term complications.

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 conditions.

Audit Risk Factors

  • Common coding errors: Misclassification of trauma-related codes.
  • Documentation gaps: Incomplete records of the incident or treatment.
  • Billing challenges: Potential denials if documentation does not support the trauma claim.

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 K08.419 lies in its potential to affect a patient's oral function and overall quality of life. Partial loss of teeth can lead to difficulties in eating and speaking, impacting nutrition and social interactions. From a population health perspective, understanding the prevalence of trauma-related dental injuries can inform preventive measures and public health initiatives. Quality measures may include tracking the incidence of such injuries and the effectiveness of treatment protocols, while healthcare utilization patterns may reflect the need for interdisciplinary care in managing trauma cases.

ICD-9 vs ICD-10

The clinical significance of K08.419 lies in its potential to affect a patient's oral function and overall quality of life. Partial loss of teeth can lead to difficulties in eating and speaking, impacting nutrition and social interactions. From a population health perspective, understanding the prevalence of trauma-related dental injuries can inform preventive measures and public health initiatives. Quality measures may include tracking the incidence of such injuries and the effectiveness of treatment protocols, while healthcare utilization patterns may reflect the need for interdisciplinary care in managing trauma cases.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the insurance provider, and common denials can occur if the documentation does not clearly establish the trauma's impact on dental health. Best practices include using precise coding, maintaining thorough records, and ensuring that all claims are submitted with appropriate supporting documentation.

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 K08.419?

K08.419 covers partial loss of teeth resulting from trauma, including fractures, avulsions, and other injuries that do not fall under specific classifications of dental disease. It is important to document the nature of the trauma and the extent of tooth loss.

When should K08.419 be used instead of related codes?

K08.419 should be used when the loss of teeth is specifically due to trauma and not due to disease processes. It is crucial to differentiate it from codes that pertain to dental diseases or congenital conditions.

What documentation supports K08.419?

Documentation should include a detailed account of the trauma incident, clinical findings, treatment provided, and any follow-up care. Radiographic evidence may also be necessary to support the diagnosis.