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ICD-10 Guide
ICD-10 CodesK08.439

K08.439

Billable

Partial loss of teeth due to caries, unspecified class

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

Code Description

ICD-10 K08.439 is a billable code used to indicate a diagnosis of partial loss of teeth due to caries, unspecified class.

Key Diagnostic Point:

K08.439 refers to partial loss of teeth due to caries, unspecified class. This condition typically presents as the loss of one or more teeth resulting from dental caries, which is the decay of tooth structure caused by bacterial action. The anatomy involved includes the teeth, specifically the enamel, dentin, and pulp, which can be progressively affected by carious lesions. Disease progression often begins with demineralization of the enamel, leading to cavities that can extend deeper into the tooth structure, potentially resulting in tooth loss if untreated. Diagnostic considerations for K08.439 include clinical examination, radiographic assessment to evaluate the extent of caries, and patient history regarding oral hygiene practices and dietary habits. It is essential to differentiate this condition from other causes of tooth loss, such as periodontal disease or trauma, to ensure appropriate management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of dental caries and its impact on tooth structure.
  • Treatment complexity: Involves various treatment options ranging from restorative procedures to extractions.
  • Documentation requirements: Requires detailed documentation of clinical findings and treatment plans.
  • Coding specificity: Must differentiate between various types of tooth loss and their causes.

Audit Risk Factors

  • Common coding errors: Misclassification of tooth loss due to other conditions.
  • Documentation gaps: Insufficient detail in clinical notes regarding the extent of caries.
  • Billing challenges: Potential denials if documentation does not support the diagnosis.

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 K08.439 lies in its association with oral health and overall well-being. Partial tooth loss due to caries can lead to functional impairments, affecting nutrition and quality of life. In terms of population health, the prevalence of dental caries remains high, necessitating effective preventive measures and treatment strategies. Quality measures related to oral health can be influenced by the management of conditions coded under K08.439, impacting healthcare utilization patterns and highlighting the need for ongoing public health initiatives.

ICD-9 vs ICD-10

The clinical significance of K08.439 lies in its association with oral health and overall well-being. Partial tooth loss due to caries can lead to functional impairments, affecting nutrition and quality of life. In terms of population health, the prevalence of dental caries remains high, necessitating effective preventive measures and treatment strategies. Quality measures related to oral health can be influenced by the management of conditions coded under K08.439, impacting healthcare utilization patterns and highlighting the need for ongoing public health initiatives.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the documentation clearly supports the diagnosis of partial tooth loss due to caries. Common denials may arise from insufficient documentation or failure to provide evidence of the carious process. Best practices include maintaining thorough clinical notes, ensuring that treatment plans align with the diagnosis, and regularly reviewing coding guidelines to stay compliant with payer requirements.

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 K08.439?

K08.439 covers partial loss of teeth specifically due to caries, without specifying the class of caries. It includes cases where the loss is not attributed to other dental conditions such as periodontal disease or trauma.

When should K08.439 be used instead of related codes?

K08.439 should be used when there is partial tooth loss specifically due to caries and when the class of caries is not specified. If the tooth loss is due to periodontal disease or other causes, different codes should be utilized.

What documentation supports K08.439?

Documentation should include clinical notes detailing the extent of caries, treatment plans, radiographic evidence of carious lesions, and any relevant patient history that supports the diagnosis of partial tooth loss due to caries.