ICD-10 Codes for Reporting Top Three Dental Conditions

by | Published on Sep 15, 2020 | Medical Coding

Dental Conditions
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Oral or dental health is an important part of your overall health and well-being. In fact, poor oral hygiene or habits can lead to serious gum disorders and cavities and has also been directly linked to diabetes, cancer and heart disease. According to the World Health Organization (WHO), between 15 and 20 percent of adults aged 35 to 44 years have severe gum disease. There are different problems that can affect your teeth including tooth decay/infection, misaligned teeth, tooth injuries and impacted tooth. Maintaining good oral hygiene from an early age is important to ensure healthy teeth and gums. Practicing regular dental care habits like – frequent brushing, flossing, and limiting your sugar intake can reduce the chances of toothache and other infections. Early identification of symptoms and other risk factors that directly contribute to dental problems can help prevent these conditions in the long run. Dental medical billing and coding can be quite challenging. When it comes to reporting symptoms and diagnoses of different dental conditions, dentists or other physicians can depend on reliable and established medical billing and coding companies. Reputable companies will have skilled medical coding service providers who are knowledgeable in the codes and other related guidelines, and can easily manage the coding and claim submission processes.

Causes and Symptoms of Dental Disorders

The oral cavity collects all sorts of bacteria, viruses, and fungi. These are quite harmless when they are in small quantities. However, poor oral hygiene and a diet high in sugar create an environment in which acid-producing bacteria can grow. This acid dissolves tooth enamel and causes dental problems or cavities. Bacteria in your gum line increase in a sticky matrix called plaque. Plaque accumulates, hardens, and migrates down the length of the tooth if it is not removed regularly by brushing and flossing.

Regular visits to a dentist will help identify a dental problem at an early stage even before the symptoms start appearing. Some of the common warning signs of dental health problems include –

  • Ulcers, sores, or tender areas in the mouth (that don’t heal after a week or two)
  • Sudden sensitivity (to hot and cold beverages)
  • Pain with chewing or biting
  • Pain or toothache
  • Loose teeth
  • Frequent dry mouth
  • Chronic bad breath
  • Bleeding or swollen gums

Three Common Dental Problems and Their ICD-10 Codes

Let’s take a look at the ICD-10 codes for three common dental conditions –

Gingivitis – A common form of gum disease, gingivitis causes swelling, redness, and irritation of the gingiva – the part of your gum around the base of your teeth. This gum condition is estimated to affect 3 out of 4 Americans during their lifetime. Poor oral hygiene is one of the most common causes of gingivitis. Having poor oral habits can cause plaque (a naturally occurring sticky film containing bacteria) to build up on the surface of the teeth causing inflammation of the surrounding gum tissue. As plaque advances, it can develop into an infection when it extends below the gum line. Generally, this gum disease occurs without any specific symptoms. In severe cases, symptoms like bright red or purple gums, tender gums (that may be painful to the touch), receding and soft gums, bad breath and bleeding from the gums when brushing or flossing, may occur. If left untreated, this condition can progress to gum disease that spreads to the underlying tissue and bone, resulting in tooth loss. Regular and timely treatment can help to reverse the symptoms of this gum condition and prevent it from progressing to a more serious gum disease and tooth loss. Treatment options for this condition include – deep cleaning your teeth, antibiotic medications, and surgery. Related ICD-10 codes include –

  • K05 Gingivitis and periodontal diseases
  • 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, non-plaque induced

Periodontitis – Periodontitis is a gum infection that damages the soft tissue and destroys the bone that supports your teeth. Also known as gum disease or periodontal disease, the dental condition occurs due to poor brushing and flossing habits that causes plaque (a sticky film of bacteria) to build up around the tooth. This may result in inflammation of the gums and cause redness, swelling and a tendency to bleed during brushing. As per reports from the Centers for Disease Control and Prevention (CDC), about half of Americans aged 30 years or older have periodontitis – the more advanced form of periodontal disease. The gum disease may progress slowly without producing any specific symptoms, even in the later stages of the disease. Some of the top symptoms include – swollen gums, pus between the teeth and gums, bad breath, bleeding gums, painful chewing and a metallic taste in the mouth. If left unchecked or untreated, the inflammation can spread down below the gums and along the roots of the teeth, causing possible destruction of the periodontal ligament and the supporting alveolar bones. Untreated periodontitis will eventually result in loosening and potential loss of teeth. Maintaining good oral hygiene can help keep the teeth and gums healthy and prevent infection in the long run. ICD-10 codes for diagnosing periodontal disease include –

  • K05 Gingivitis and periodontal diseases
  • K05.2 Aggressive periodontitis
    • K05.20 Aggressive periodontitis, unspecified
    • K05.21 Aggressive periodontitis, localized
      • K05.211 Aggressive periodontitis, localized, slight
      • K05.212 Aggressive periodontitis, localized, moderate
      • K05.213 Aggressive periodontitis, localized, severe
      • K05.219 Aggressive periodontitis, localized, unspecified severity
    • K05.22 Aggressive periodontitis, generalized
      • K05.221 Aggressive periodontitis, generalized, slight
      • K05.222 Aggressive periodontitis, generalized, moderate
      • K05.223 Aggressive periodontitis, generalized, severe
      • K05.229 Aggressive periodontitis, generalized, unspecified severity
  • K05.3 Chronic periodontitis
    • K05.30 Chronic periodontitis, unspecified
    • K05.31 Chronic periodontitis, localized
      • 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
    • K05.32 Chronic periodontitis, generalized
      • 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 Periodontosis
  • K05.5 Other periodontal diseases
  • K05.6 Periodontal disease, unspecified

Dental Caries – Also called tooth decay or cavities, dental caries is the permanent destruction of tooth enamel – the hard, outer layer of the teeth that develop into tiny openings or holes. The dental problem is caused by a specific, sticky film of bacteria called plaque that forms on the teeth. If left untreated, the condition can get worse and affect the deeper layers of the teeth causing toothache, infection and tooth loss. Inadequate brushing, tooth fracture or abscess, prevalence of mouth plaque, cavity formation and frequent unhealthy snacking habits are the top causes of the condition. The condition can affect the teeth at any age; however, it is most common among children and young adults. Generally, the early stage of dental caries may not show any specific signs or symptoms. However, as the tooth decay worsens, certain signs and symptoms like toothache, tooth sensitivity, visible holes or pits in your teeth, pain when biting and brown, black or white staining on any surface of a tooth may occur. Treatment options include – fluoride treatments, fillings, root canals, crowns and tooth extractions.

ICD-10 codes for dental caries include –

  • K02 Dental caries
  • 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
  • K02.6 Dental caries on smooth surface
    • K02.61 Dental caries on smooth surface, limited to enamel
    • K02.62 Dental caries on smooth surface, penetrating into dentin
    • K02.63 Dental caries on smooth surface, penetrating into pulp
  • K02.7 Dental root caries
  • K02.9 Dental caries, unspecified

Practicing good, consistent oral hygiene and stopping activities that damage or stress the mouth lining are the best ways to prevent dental disorders. Make a habit to brush your teeth twice daily with fluoride toothpaste. Floss your teeth every day. Eat a healthy, balanced diet and get regular professional dental cleanings as recommended by your dentist. Other prevention strategies include – stopping smoking or chewing tobacco, stopping the consumption of alcohol, eating antioxidant-rich foods, avoiding abrasive dental hygiene products (like whiteners and rinses), attending routine dental exams and maintaining dental hygiene.

Medical billing and coding for dental disorders can be complex. For accurate and timely billing and claims submission, dental practices can outsource their medical coding tasks to a reliable medical billing and coding company that provides the services of AAPC-certified coding specialists.

Rajeev Rajagopal

Rajeev Rajagopal, the President of OSI, has a wealth of experience as a healthcare business consultant in the United States. He has a keen understanding of current medical billing and coding standards.

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