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ICD-10 Guide
ICD-10 CodesK11.0

K11.0

Billable

Atrophy of salivary gland

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

Code Description

ICD-10 K11.0 is a billable code used to indicate a diagnosis of atrophy of salivary gland.

Key Diagnostic Point:

Atrophy of the salivary gland, classified under ICD-10 code K11.0, refers to the reduction in size and function of the salivary glands, which can lead to decreased saliva production. Clinically, patients may present with dry mouth (xerostomia), difficulty swallowing (dysphagia), and increased dental caries due to reduced oral moisture. The major salivary glands involved include the parotid, submandibular, and sublingual glands. Atrophy can result from various etiologies, including autoimmune disorders (such as Sjögren's syndrome), radiation therapy, chronic inflammation, and certain medications. Disease progression may lead to significant oral health issues, impacting nutrition and quality of life. Diagnostic considerations include a thorough patient history, physical examination, and imaging studies such as sialography or ultrasound to assess gland structure and function. Salivary flow rate tests may also be employed to quantify saliva production, aiding in the diagnosis of atrophy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differential diagnosis to rule out other causes of xerostomia.
  • Treatment complexity: Management may involve multidisciplinary approaches including dental care, medication adjustments, and possibly salivary substitutes.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: Requires precise coding to differentiate from other salivary gland disorders.

Audit Risk Factors

  • Common coding errors: Misclassification with other salivary gland disorders.
  • Documentation gaps: Inadequate clinical notes regarding symptoms and treatment.
  • Billing challenges: Potential denials if the medical necessity is not clearly established.

Specialty Focus

Medical Specialties

Otolaryngology

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K11.0 lies in its potential to affect oral health and overall quality of life. Population health impact includes increased risk for dental issues and nutritional deficiencies among affected individuals. Quality measures may focus on the management of xerostomia and its complications, while healthcare utilization patterns may reflect increased visits to dental and medical providers for management of symptoms and associated conditions. Epidemiologically, understanding the prevalence of salivary gland atrophy can inform public health strategies aimed at improving oral health outcomes.

ICD-9 vs ICD-10

The clinical significance of K11.0 lies in its potential to affect oral health and overall quality of life. Population health impact includes increased risk for dental issues and nutritional deficiencies among affected individuals. Quality measures may focus on the management of xerostomia and its complications, while healthcare utilization patterns may reflect increased visits to dental and medical providers for management of symptoms and associated conditions. Epidemiologically, understanding the prevalence of salivary gland atrophy can inform public health strategies aimed at improving oral health outcomes.

Reimbursement & Billing Impact

Reimbursement may depend on demonstrating medical necessity, particularly if the patient requires additional interventions such as dental care or saliva substitutes. Common denials may arise from insufficient documentation or failure to provide evidence of the impact of atrophy on the patient's health. Best practices include maintaining comprehensive records of patient interactions and treatment plans to support claims.

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 K11.0?

K11.0 covers conditions leading to atrophy of the salivary glands, primarily due to autoimmune diseases, radiation exposure, or chronic inflammation. It is important to differentiate it from other salivary gland disorders such as infections or obstructions.

When should K11.0 be used instead of related codes?

K11.0 should be used when there is a confirmed diagnosis of salivary gland atrophy, particularly when accompanied by symptoms of dry mouth and reduced saliva production, distinguishing it from conditions like sialadenitis or sialolithiasis.

What documentation supports K11.0?

Documentation should include a detailed patient history, clinical findings of xerostomia, results from salivary flow tests, and any imaging studies performed. Evidence of underlying conditions contributing to gland atrophy should also be documented.