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ICD-10 Guide
ICD-10 CodesK08.52

K08.52

Billable

Unrepairable overhanging of dental restorative materials

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

Code Description

ICD-10 K08.52 is a billable code used to indicate a diagnosis of unrepairable overhanging of dental restorative materials.

Key Diagnostic Point:

K08.52 refers to unrepairable overhanging of dental restorative materials, which can significantly impact oral health. Clinically, this condition may present as a visible overhang of dental materials, such as fillings or crowns, that extend beyond the natural contours of the tooth. This can lead to plaque accumulation, gingival irritation, and potential periodontal disease. The anatomy involved includes the affected tooth, surrounding gingival tissues, and the dental restorative materials themselves. Disease progression can result in further decay of the tooth structure, loss of supporting bone, and increased risk of tooth loss if not addressed. Diagnostic considerations include a thorough clinical examination, radiographic evaluation to assess the extent of decay or damage, and patient history to determine the longevity and type of restorative materials used. Proper identification and management of this condition are crucial to prevent complications and maintain oral health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misclassification of the type of overhang.
  • Documentation gaps may arise if the clinical rationale for unrepairability is not clearly stated.
  • Billing challenges can occur if the condition is not adequately supported by clinical evidence.

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 K08.52 lies in its potential to lead to further oral health complications, including tooth loss and systemic health issues associated with periodontal disease. Population health impact is notable, as untreated dental conditions can contribute to increased healthcare utilization and costs. Quality measures may include tracking the incidence of such conditions and ensuring timely interventions to improve patient outcomes.

ICD-9 vs ICD-10

The clinical significance of K08.52 lies in its potential to lead to further oral health complications, including tooth loss and systemic health issues associated with periodontal disease. Population health impact is notable, as untreated dental conditions can contribute to increased healthcare utilization and costs. Quality measures may include tracking the incidence of such conditions and ensuring timely interventions to improve patient outcomes.

Reimbursement & Billing Impact

reimbursement.

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 K08.52?

K08.52 specifically covers cases where dental restorative materials are overhanging and deemed unrepairable, often leading to complications such as decay or periodontal issues. It is essential to differentiate this from repairable conditions to ensure appropriate treatment and coding.

When should K08.52 be used instead of related codes?

K08.52 should be used when the overhanging restorative material cannot be repaired and poses a risk to the patient's oral health. If the overhang is repairable, K08.51 should be selected instead.

What documentation supports K08.52?

Documentation must include clinical notes detailing the examination findings, radiographic evidence of the unrepairable condition, and any treatment plans discussed with the patient. Clear justification for the unrepairability of the restorative material is crucial.