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ICD-10 Guide
ICD-10 CodesK08.433

K08.433

Billable

Partial loss of teeth due to caries, class III

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

Code Description

ICD-10 K08.433 is a billable code used to indicate a diagnosis of partial loss of teeth due to caries, class iii.

Key Diagnostic Point:

K08.433 refers to partial loss of teeth due to caries, class III, which indicates significant dental decay leading to the loss of tooth structure. Clinically, this condition presents with visible cavities, tooth sensitivity, and potential pain, impacting the patient's ability to chew and speak. The anatomy involved primarily includes the affected teeth and surrounding periodontal structures. Disease progression typically begins with the initial formation of carious lesions, which, if untreated, can lead to deeper decay and eventual tooth loss. Diagnostic considerations include clinical examination, radiographic assessment, and patient history to evaluate the extent of caries and associated symptoms. Early intervention is crucial to prevent further deterioration and potential complications such as infections or abscesses. Treatment may involve restorative procedures like fillings or crowns, and in severe cases, extraction may be necessary. Proper coding and documentation are essential for accurate representation of the patient's condition and treatment plan.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough clinical evaluation and imaging.
  • Treatment complexity: Involves various treatment modalities depending on severity.
  • Documentation requirements: Detailed records of clinical findings and treatment plans are necessary.
  • Coding specificity: Requires precise coding to differentiate from other dental conditions.

Audit Risk Factors

  • Common coding errors: Misclassification of caries severity can lead to incorrect coding.
  • Documentation gaps: Incomplete records may result in denials or audits.
  • Billing challenges: Variability in treatment approaches can complicate reimbursement.

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K08.433 lies in its association with oral health and overall well-being. Partial loss of teeth can affect nutrition, speech, and self-esteem, leading to broader health implications. In terms of population health, understanding the prevalence of dental caries and its impact on healthcare utilization patterns is crucial for preventive measures. Quality measures related to dental health can help in monitoring and improving patient outcomes, emphasizing the importance of early intervention and comprehensive dental care.

ICD-9 vs ICD-10

The clinical significance of K08.433 lies in its association with oral health and overall well-being. Partial loss of teeth can affect nutrition, speech, and self-esteem, leading to broader health implications. In terms of population health, understanding the prevalence of dental caries and its impact on healthcare utilization patterns is crucial for preventive measures. Quality measures related to dental health can help in monitoring and improving patient outcomes, emphasizing the importance of early intervention and comprehensive dental care.

Reimbursement & Billing Impact

reimbursement policies related to dental caries treatment and ensure that all coding aligns with the services provided to minimize billing challenges.

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 K08.433?

K08.433 specifically covers cases of partial tooth loss due to class III caries, which indicates extensive decay affecting the tooth structure significantly but not resulting in complete loss. It is essential to document the extent of decay and any associated symptoms.

When should K08.433 be used instead of related codes?

K08.433 should be used when there is clear evidence of partial tooth loss due to class III caries. It is differentiated from class I and II codes based on the severity of decay and the extent of tooth structure loss.

What documentation supports K08.433?

Documentation should include clinical findings from examinations, radiographic images showing the extent of caries, treatment plans, and any patient-reported symptoms. Comprehensive records are crucial for justifying the use of this code.