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ICD-10 Guide
ICD-10 CodesK08.421

K08.421

Billable

Partial loss of teeth due to periodontal diseases, class I

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

Code Description

ICD-10 K08.421 is a billable code used to indicate a diagnosis of partial loss of teeth due to periodontal diseases, class i.

Key Diagnostic Point:

K08.421 refers to partial loss of teeth due to periodontal diseases, class I, which is characterized by the loss of one or more teeth as a result of periodontal disease, specifically in the early stages. Periodontal disease begins with gingivitis, which can progress to periodontitis if not treated. This condition affects the supporting structures of the teeth, including the gums and bone, leading to tooth mobility and eventual loss. The clinical presentation may include gum inflammation, bleeding during brushing, and the presence of pockets between the teeth and gums. The anatomy involved primarily includes the gingiva, alveolar bone, and periodontal ligament. Disease progression can vary based on individual risk factors such as oral hygiene, smoking, and systemic health conditions. Diagnostic considerations include clinical examination, radiographic evaluation, and periodontal probing to assess the extent of attachment loss and pocket depth. Early intervention is crucial to prevent further tooth loss and manage the underlying periodontal disease effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough clinical evaluation and understanding of periodontal disease stages.
  • Treatment complexity: Involves multidisciplinary approaches including dental cleanings, possible surgical interventions, and ongoing maintenance.
  • Documentation requirements: Detailed records of periodontal assessments, treatment plans, and patient compliance are necessary.
  • Coding specificity: Requires precise coding to differentiate between various types of periodontal diseases and their effects.

Audit Risk Factors

  • Common coding errors: Misclassification of the extent of tooth loss or failure to document periodontal disease stage.
  • Documentation gaps: Incomplete records of periodontal assessments or treatment plans.
  • Billing challenges: Potential denials due to lack of supporting documentation for the diagnosis and treatment provided.

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: Periodontics

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 K08.421 lies in its association with periodontal disease, which affects a substantial portion of the adult population and can lead to systemic health issues if untreated. Understanding and managing partial tooth loss due to periodontal diseases can improve patient outcomes and quality of life. Population health impact includes the need for preventive dental care and education on oral hygiene practices to reduce the prevalence of periodontal diseases. Epidemiologically, the condition is linked to various risk factors, including age, smoking, and diabetes, highlighting the importance of targeted interventions.

ICD-9 vs ICD-10

The clinical significance of K08.421 lies in its association with periodontal disease, which affects a substantial portion of the adult population and can lead to systemic health issues if untreated. Understanding and managing partial tooth loss due to periodontal diseases can improve patient outcomes and quality of life. Population health impact includes the need for preventive dental care and education on oral hygiene practices to reduce the prevalence of periodontal diseases. Epidemiologically, the condition is linked to various risk factors, including age, smoking, and diabetes, highlighting the importance of targeted interventions.

Reimbursement & Billing Impact

Reimbursement considerations include verifying the patient's insurance coverage for periodontal treatments, as some plans may have specific criteria for coverage. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for the procedures performed. Best practices include maintaining thorough records of clinical findings, treatment plans, and patient follow-up to support claims and reduce the risk of audits.

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 K08.421?

K08.421 covers partial loss of teeth specifically due to periodontal diseases classified as class I, which indicates early stages of periodontal disease with some attachment loss but not extensive tooth mobility or loss.

When should K08.421 be used instead of related codes?

K08.421 should be used when there is documented evidence of partial tooth loss due to periodontal disease, particularly in early stages. If there is complete loss of teeth or advanced periodontal disease, other codes such as K08.420 should be considered.

What documentation supports K08.421?

Documentation should include clinical findings from periodontal examinations, radiographic evidence showing bone loss, treatment plans, and patient compliance with oral hygiene practices.