Codes For Common Oral Problems During Pregnancy

by | Last updated Mar 2, 2023 | Published on Feb 11, 2022 | Medical Coding

Oral Problems
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Pregnancy is a unique phase of a woman’s life as there are considerable physiological changes that can adversely affect the oral health of women. Maintaining oral health is vital to ensure overall well-being and health. Dental services may be reimbursed and dentists can partner with a reliable dental billing company to accurately code their diagnoses and treatments provided.

Dentists provide preventive, diagnostic and restorative dental treatment for the following commonoral health problems:

  • Gingivitis- Fluctuations in hormones can induce the response to bacteria in the gum tissue.
  • Dental caries- Changes in diet and increased craving for sugary foods can cause tooth pain and infection. Nausea and vomiting increases acidity in the mouth.
  • Pyogenic granuloma-Inflammatory hyperplasia around anterior teeth due to hormonal changes.
  • Erosion of teeth- It stems from vomiting associated with morning sickness.
  • Periodontitis-Pregnant women have increased risk of peridiontitis due to hormonal changes.

Codes for Common Oral Problems

Dental Examination and Cleaning

ICD-10-CM code(s)

  • ZO1.20: Encounter for dental examination and cleaning without abnormal findings.
  • ZO1.21: Encounter for dental examination and cleaning with abnormal findings.
  • Z13.84: Encounter screening for dental disorders.

CDT Code(s)

D0120: Periodic oral evaluation- established patient

  • D0140: Limited oral evaluation-problem focused
  • D0150: Comprehensive oral evaluation-new or established patient
  • D0160: Detailed and extensive oral evaluation-problem focused, by report
  • D0210: Intraoral-complete series of radiographic Images
  • D0220: Intraoral-periapical first radiographic image
  • D0230: Intraoral-periapical each additional film
  • D0251: Extra-oral posterior dental radiographic image
  • D0272: Bitewings-two radiographic images
  • D0274: Bitewings-four radiographic images
  • D0330: Panoramic radiographic image
  • D0999: Unspecified diagnostic procedure, by report

Gingivitis

ICD-10-CM code(s)

  • K05.0: Acute gingivitis
  • K05.00: Acute gingivitis, plaque induced
  • K05.01: Acute gingivitis, non-plaque induced.
  • K05.1: Chronic gingivitis
  • K05.10: Chronic gingivitis, plaque induced
  • K05.11 Chronic gingivitis, on-plaque induced

CDT code(s)

  • D 9110: Palliative (emergency) treatment of dental pain-minor procedure
  • D4210: Gingivectomy or gingivoplasty – four or more contiguous teeth or tooth bounded spaces per quadrant.
  • D4211: Gingivectomy or Gingivoplasty – one to three contagious teeth or tooth bounded spaces per quadrant.
  • D 4212: Gingivectomy or gingivoplasty to allow access for restorative procedure, per tooth

Dental Caries

ICD-10-CM code(s)

  • K02.3: Arrested dental caries
  • K02.5: Dental caries on pit and fissure surface
    • K02.51: Dental caries on pit and fissure surface limited to enamel.
    • K02.52: Dental caries on pit and fissure surface penetrating into dentin.
    • K02.53: Dental caries on pit and fissure surface penetrating into pulp.
    • K02.63: Dental caries on smooth surface penetrating into pulp
  • K02.7: Dental root caries
  • K02.9: Unspecified dental caries

CDT Code(s)

  • D1330: Oral hygiene instructions
  • D0601: Caries risk assessment and documentation, with a finding of low risk
  • D0602: Caries risk assessment and documentation, with a finding of moderate risk
  • D0603: Caries risk assessment and documentation, with a finding of high risk

Pyogenic granuloma

  • K13.4: Granuloma and granuloma-like lesions of oral mucosa
    • Eosinophilic granuloma
    • Granuloma pyogenicum
    • Verrucous xanthoma

Erosion of teeth

ICD-10-CM code(s)

  • K03.2: Erosion of teeth
  • K03.3: Pathological resorption of teeth
  • K03.7: Posteruptive color changes of dental hard tissues

CDT code(s)

  • D7880: Occlusal orthotic device, by report
  • D7881: Occlusal orthotic device adjustment
  • D1206: Topical application of fluoride varnish
  • D1208: Topical application of fluoride-excluding Varnish
  • D1310: Nutritional counseling for control of dental disease

Periodontitis

ICD -10- CM code(s)

K05.2: Aggressive periodontitis
K04.20: Unspecified aggressive periodontitis
K05.21: Aggressive periodontitis, localized.
K05.221: Aggressive periodontitis, generalized, slight
K05.222: Acute periodontitis, generalized, moderate
K05.223: Aggressive periodontitis, generalized, severe.
K05.3: Chronic periodontitis
K05.30: Chronic periodontitis, unspecified.
K05.311: Chronic periodontitis, localized, slight
K05.312: Chronic periodontitis, localized, moderate
K05.313: Chronic periodontitis, localized, severe
K05.319: Chronic periodontitis, localized, unspecified severity
K05.321: Chronic periodontitis, generalized, slight
K05.322: Chronic periodontitis, generalized, moderate
K05.323: Chronic periodontitis, generalized, severe.
K05.329: Chronic periodontitis, generalized, unspecified severity
K05.4: Periodontitis
K05.5: Other periodontal diseases
K05.6: Unspecified periodontal disease

CDT code(s)

D4341: Periodontal scaling and root planning-four or more teeth quadrant.
D4342: Periodontal scaling and root planning- one to three teeth per quadrant
D4910: Periodontal maintenance
D4381: Localized delivery of antimicrobial agents via controlled release vehicle into diseased crevicular tissue, per tooth

Dentists providing specialized care to pregnant women presenting with various dental problems find the coding of dental problems hectic and time-consuming. A medical billing and coding company can assist dentists with accurate dental coding and ensure speedy claims processing while minimizing denials. With a good outsourcing dental billing partner, dentists can focus on treating their patients and ensuring optimum care and patient satisfaction.

Julie Clements

Julie Clements, OSI’s Vice President of Operations, brings a diverse background in healthcare staffing and a robust six-year tenure as the Director of Sales and Marketing at a prestigious 4-star resort.

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