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ICD-10 Guide
ICD-10 CodesK08.422

K08.422

Billable

Partial loss of teeth due to periodontal diseases, class II

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

Code Description

ICD-10 K08.422 is a billable code used to indicate a diagnosis of partial loss of teeth due to periodontal diseases, class ii.

Key Diagnostic Point:

K08.422 refers to partial loss of teeth due to periodontal diseases, class II. This condition is characterized by the loss of one or more teeth as a direct result of periodontal disease, which involves inflammation and infection of the supporting structures of the teeth, including the gums and bone. Clinically, patients may present with gum recession, pockets forming between the teeth and gums, and eventual tooth mobility. The anatomy involved primarily includes the periodontal ligament, alveolar bone, and gingival tissue. Disease progression typically starts with gingivitis, leading to periodontitis if untreated, ultimately resulting in tooth loss. Diagnostic considerations include clinical examination, radiographic evaluation, and periodontal probing to assess the extent of periodontal attachment loss. Proper diagnosis is crucial for determining the appropriate treatment plan, which may involve scaling and root planing, surgical interventions, or restorative dentistry to manage the consequences of tooth loss.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough periodontal assessment and may involve multiple diagnostic tools.
  • Treatment complexity: Treatment can vary widely based on the severity of periodontal disease and may require interdisciplinary approaches.
  • Documentation requirements: Detailed documentation of periodontal status and treatment plans is essential for accurate coding.
  • Coding specificity: K08.422 is specific to partial tooth loss due to periodontal disease, necessitating precise coding to reflect the patient's condition.

Audit Risk Factors

  • Common coding errors: Misclassification of the severity of periodontal disease can lead to incorrect coding.
  • Documentation gaps: Inadequate documentation of periodontal assessments may result in denials or audits.
  • Billing challenges: Variability in treatment approaches can complicate billing and reimbursement processes.

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K08.422 lies in its association with periodontal disease, which affects a substantial portion of the population and can lead to systemic health issues if untreated. Understanding and addressing partial tooth loss due to periodontal disease can improve patient outcomes, enhance quality of life, and reduce healthcare utilization related to dental and systemic complications. Epidemiologically, periodontal disease is prevalent and can significantly impact overall health, making effective management crucial.

ICD-9 vs ICD-10

The clinical significance of K08.422 lies in its association with periodontal disease, which affects a substantial portion of the population and can lead to systemic health issues if untreated. Understanding and addressing partial tooth loss due to periodontal disease can improve patient outcomes, enhance quality of life, and reduce healthcare utilization related to dental and systemic complications. Epidemiologically, periodontal disease is prevalent and can significantly impact overall health, making effective management crucial.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of detailed records that justify the treatment plan and the specific procedures performed. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include ensuring that all periodontal assessments and treatment notes are thorough and clearly outline the rationale for the chosen interventions, as well as adherence to payer-specific guidelines for coding and billing.

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 K08.422?

K08.422 specifically covers partial loss of teeth due to periodontal diseases classified as class II, which indicates moderate periodontal disease with some attachment loss and tooth mobility.

When should K08.422 be used instead of related codes?

K08.422 should be used when there is documented partial tooth loss specifically attributed to periodontal disease, distinguishing it from complete loss or loss due to other causes.

What documentation supports K08.422?

Documentation should include periodontal examination findings, radiographic evidence of bone loss, treatment plans, and progress notes detailing the management of periodontal disease.