ICD-10 Guide

R19.6

Halitosis

BILLABLE STATUSYes

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/11/2025

Code Description

ICD-10 R19.6 is a billable code used to indicate a diagnosis of halitosis.

Key Diagnostic Point:

Halitosis, commonly referred to as bad breath, is a condition characterized by an unpleasant odor emanating from the mouth. This symptom can be transient or chronic and may arise from various underlying causes. The most common etiology includes poor oral hygiene, which leads to the accumulation of food particles and bacteria in the mouth, resulting in the production of volatile sulfur compounds. Other potential causes include dental issues such as periodontal disease, dry mouth (xerostomia), systemic conditions like diabetes or liver disease, and certain medications that can alter salivary flow. Halitosis can also be exacerbated by dietary factors, such as the consumption of garlic or onions. Clinically, it is important to assess the patient's oral hygiene practices, dental health, and any associated symptoms to determine the underlying cause. A thorough examination may include checking for signs of oral infections, assessing salivary function, and considering systemic health issues that could contribute to the symptom.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

Variety of potential underlying causes
Need for thorough patient history and examination
Differentiation from other similar symptoms
Documentation of associated conditions

Audit Risk Factors

Inadequate documentation of the underlying cause
Failure to link halitosis to a specific diagnosis
Misclassification as a primary diagnosis without supporting evidence
Lack of follow-up documentation for chronic cases

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed patient history, including oral hygiene practices and systemic health review.

Common Clinical Scenarios

Patients presenting with chronic halitosis and associated symptoms like dry mouth or diabetes.

Billing Considerations

Consideration of systemic diseases that may contribute to halitosis, requiring comprehensive documentation.

Emergency Medicine

Documentation Requirements

Acute assessment of halitosis in the context of other presenting symptoms.

Common Clinical Scenarios

Patients with acute onset of halitosis possibly related to an underlying infection or metabolic condition.

Billing Considerations

Rapid evaluation of potential life-threatening conditions that may present with halitosis.

Coding Guidelines

Inclusion Criteria

Use R19.6 When

According to ICD
10 coding guidelines, R19
6 should be used when halitosis is the primary symptom and not attributable to a more specific diagnosis
Documentation must support the diagnosis and any associated conditions

Exclusion Criteria

Do NOT use R19.6 When

No specific exclusions found.

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used when evaluating a patient with halitosis and associated conditions.

Documentation Requirements

Document the history, examination findings, and any treatment plans.

Specialty Considerations

Internal medicine providers should focus on systemic evaluations.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of halitosis, improving the ability to capture underlying causes and associated conditions, which enhances clinical data accuracy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of halitosis, improving the ability to capture underlying causes and associated conditions, which enhances clinical data accuracy.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of halitosis, improving the ability to capture underlying causes and associated conditions, which enhances clinical data accuracy.

Resources

Clinical References

•
ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

•
ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the primary cause of halitosis?

The primary cause of halitosis is often poor oral hygiene, leading to the accumulation of bacteria and food particles in the mouth.

Can halitosis be a sign of a serious condition?

Yes, halitosis can indicate underlying systemic conditions such as diabetes or liver disease, necessitating further evaluation.

ICD-10 R19.6 is a billable code used to indicate a diagnosis of halitosis.