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ICD-10 Guide
ICD-10 CodesK08.81

K08.81

Billable

Primary occlusal trauma

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

Code Description

ICD-10 K08.81 is a billable code used to indicate a diagnosis of primary occlusal trauma.

Key Diagnostic Point:

Primary occlusal trauma refers to dental injuries resulting from excessive occlusal forces on a tooth or teeth that are otherwise healthy. This condition can lead to various clinical presentations, including tooth mobility, sensitivity, and pain, as well as potential damage to the supporting structures such as the periodontal ligament and alveolar bone. The anatomy involved primarily includes the teeth, periodontal tissues, and the temporomandibular joint (TMJ). Disease progression may involve the development of secondary occlusal trauma if the primary cause is not addressed, leading to further complications such as periodontal disease or tooth loss. Diagnostic considerations include a thorough clinical examination, radiographic evaluation, and assessment of occlusal relationships. It is essential to differentiate primary occlusal trauma from secondary occlusal trauma, which occurs in teeth with existing periodontal disease or other dental conditions. Proper diagnosis and management are crucial to prevent long-term complications and ensure optimal 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
  • Documentation gaps
  • Billing challenges

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 K08.81 lies in its potential to affect oral health and overall well-being. Untreated primary occlusal trauma can lead to increased healthcare utilization due to complications such as tooth loss or periodontal disease. Understanding the epidemiology of occlusal trauma can help healthcare providers implement preventive measures and improve patient outcomes, ultimately enhancing population health.

ICD-9 vs ICD-10

The clinical significance of K08.81 lies in its potential to affect oral health and overall well-being. Untreated primary occlusal trauma can lead to increased healthcare utilization due to complications such as tooth loss or periodontal disease. Understanding the epidemiology of occlusal trauma can help healthcare providers implement preventive measures and improve patient outcomes, ultimately enhancing population health.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of the procedure and the patient's insurance coverage. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that all relevant details are included in the patient's record to support the use of K08.81 and related procedure codes, adhering to payer-specific guidelines for optimal 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 K08.81?

K08.81 covers conditions where occlusal forces cause trauma to otherwise healthy teeth, leading to symptoms such as mobility, pain, and sensitivity without pre-existing periodontal disease.

When should K08.81 be used instead of related codes?

K08.81 should be used when the trauma is primary and there are no underlying periodontal issues. If there are existing conditions, K08.82 may be more appropriate.

What documentation supports K08.81?

Documentation should include clinical findings, radiographic evidence, and a detailed history of occlusal forces affecting the teeth, as well as treatment plans and outcomes.