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ICD-10 Guide
ICD-10 CodesK09.0

K09.0

Billable

Developmental odontogenic cysts

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

Code Description

ICD-10 K09.0 is a billable code used to indicate a diagnosis of developmental odontogenic cysts.

Key Diagnostic Point:

Developmental odontogenic cysts are a type of cystic lesion that arise from the tissues involved in tooth development. These cysts are typically found in the jawbone and can be asymptomatic or present with symptoms such as swelling, pain, or infection. The most common types of developmental odontogenic cysts include dentigerous cysts, which are associated with the crowns of unerupted teeth, and odontogenic keratocysts, which are characterized by their aggressive behavior and potential for recurrence. The anatomy involved primarily includes the maxilla and mandible, where these cysts can disrupt normal dental development and alignment. Disease progression can vary; while some cysts remain stable, others may expand and cause significant bone resorption. Diagnostic considerations include imaging studies such as panoramic radiographs or CT scans, which help in visualizing the cyst's size, location, and relationship to adjacent structures. A definitive diagnosis is often made through histological examination following surgical excision.

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 misclassifying the type of cyst.
  • Documentation gaps may arise if the clinical rationale for surgery is not clearly stated.
  • Billing challenges can occur if the procedure is not adequately supported by clinical evidence.

Specialty Focus

Medical Specialties

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

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

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

Developmental odontogenic cysts can significantly impact oral health, leading to complications such as infection, tooth displacement, and bone loss. Their prevalence in the population underscores the importance of early detection and management. Quality measures in dental care often include monitoring for these cysts, as timely intervention can reduce healthcare utilization and improve patient outcomes.

ICD-9 vs ICD-10

Developmental odontogenic cysts can significantly impact oral health, leading to complications such as infection, tooth displacement, and bone loss. Their prevalence in the population underscores the importance of early detection and management. Quality measures in dental care often include monitoring for these cysts, as timely intervention can reduce healthcare utilization and improve patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the surgical intervention and the necessity of imaging studies. Common denials may arise from insufficient documentation or incorrect coding of the procedure. Best practices include ensuring that all clinical notes support the diagnosis and that the procedure codes accurately reflect the treatment provided.

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 K09.0?

K09.0 specifically covers developmental odontogenic cysts, including dentigerous cysts and odontogenic keratocysts. These conditions are characterized by their origin from the dental tissues and their potential impact on dental health.

When should K09.0 be used instead of related codes?

K09.0 should be used when the cyst is specifically identified as developmental and odontogenic in nature. If the cyst is inflammatory or acquired, other codes such as K09.1 may be more appropriate.

What documentation supports K09.0?

Documentation should include clinical findings, imaging results, and histopathological reports confirming the diagnosis of a developmental odontogenic cyst. Detailed notes on the patient's symptoms and treatment plan are also essential.