Reporting Two Common Dental Problems and Their ICD 10 Codes

September 17, 2022, Outsource Strategies International

In many cases, poor dental hygiene, aging and other chronic medical conditions (such as diabetes and heart disease) can make people vulnerable to different dental problems. In addition, oral diseases are also associated with risk behaviors such as using tobacco and consuming sugary foods and beverages. According to reports from the Centers for Disease Control and Prevention (CDC), more than 40 percent of adults report having felt pain in their mouth within the last year, and more than 80 percent of people will have had at least one cavity by age 34. It is estimated that the nation spends more than $124 billion on costs related to dental care each year. Billing and coding for different types of dental conditions can be challenging. Dental offices and dental billing companies must be up-to-date with the correct medical codes and payer guidelines to ensure accurate claim submission.

Here listed are two common dental conditions and their related ICD-10 codes -

Dental Caries – Also called tooth decay or cavities, dental caries cause permanent destruction of the tooth enamel – the hard, outer layer of the teeth – that later develop into tiny holes or openings. If left untreated, these openings can get larger and affect deeper layers of the teeth. The condition is caused by a combination of factors like –bacteria in the mouth, frequent snacking, sipping sugary drinks, tooth fracture or tooth abscess and inadequate brushing. The signs and symptoms associated with the condition may vary, depending on the severity, extent and location of cavities. In the early stages of the condition, most people do not experience any specific symptoms at all. However, as the condition gets larger, it can cause several symptoms like – toothache, tooth sensitivity, mild to sharp pain (when eating or drinking something sweet, hot or cold), visible holes or pits in the teeth and brown, and black or white staining on any surface of a tooth. Diagnosis of the condition begins with a detailed dental examination wherein a dentist may probe the mouth and teeth with certain dental instruments and check for soft areas. They may enquire about tooth pain and sensitivity. Dental X-rays may also be taken to analyze the extent of cavities and decay. Regular checkups can identify the cavities at an early stage before they cause severe symptoms. Treatment modalities include a combination of fluoride treatments, fillings (also called restorations – made of various materials, such as tooth-colored composite resins, porcelain or dental amalgam), root canals, crowns and tooth extractions. ICD-10 diagnosis codes for dental caries include –

K02 Dental caries

K02.3 Arrested dental caries

K02.5 Dental caries on pit and fissure surface

• K02.51 …… limited to enamel
• K02.52 …… penetrating into dentin
• K02.53 …… penetrating into pulp

K02.6 Dental caries on smooth surface

• K02.61 …… limited to enamel
• K02.62 …… penetrating into dentin
• K02.63 …… penetrating into pulp

K02.7 Dental root caries

K02.9 Dental caries, unspecified

Periodontitis – Also called gum disease, this condition damages the soft tissue and destroys the bone that supports the teeth. The condition is normally caused by poor dental hygiene habits. Maintaining poor dental hygiene (like improper brushing and flossing habits) leads to the buildup of plaque (a sticky film of bacteria) around the tooth. This can destroy the bone that supports the teeth and cause the teeth to loosen. Common symptoms of gum disease include - swollen gums, pus between the teeth and gums, bad breath, bleeding gums, painful chewing and a metallic taste in the mouth. Diagnosis of this gum disease involves a dental examination and medical history review to identify any additional factors like – smoking or usage of certain medications - that could be contributing to the symptoms. Dental X-rays may also be performed to check for bone loss in areas where the dentist observes deeper pocket depths. Treatment for gum disease aims to clean the pockets around the teeth and prevent damage to the surrounding bone. Common treatment modalities include – antibiotic medications, root planing, scaling and certain surgical treatments like flap surgery, bone grafting, soft tissue grafts and guided tissue regeneration. As the condition occurs due to poor oral hygiene, maintaining good oral habits like – brushing at least twice a day, flossing daily and getting regular dental checkups – can help keep the teeth and gums healthy and prevent infection in the long run. ICD-10 diagnosis codes for periodontitis include –

K05 Gingivitis and periodontal diseases

K05.2 Aggressive periodontitis

K05.20 …… unspecified

K05.21 Aggressive periodontitis, localized

• K05.211 …… slight
• K05.212 …… moderate
• K05.213 …… severe
• K05.219 …… unspecified severity

K05.22 Aggressive periodontitis, generalized

• K05.221 …… slight
• K05.222 …… moderate
• K05.223 …… severe
• K05.229 …… unspecified severity

K05.3 Chronic periodontitis

K05.30 …… unspecified

K05.31 Chronic periodontitis, localized

• K05.311 …… slight
• K05.312 …… moderate
• K05.313 …… severe
• K05.319 …… unspecified severity

K05.32 Chronic periodontitis, generalized

• K05.321 …… slight
• K05.322 …… moderate
• K05.323 …… severe
• K05.329 …… unspecified severity

K05.4 Periodontosis

K05.5 Other periodontal diseases

K05.6 Periodontal disease, unspecified

Practicing good dental habits can help minimize teeth damage and prevent the occurrence of dental problems. These include – brushing the teeth twice daily with fluoride toothpaste, flossing the teeth every day and undergoing regular and professional dental cleanings. Other prevention strategies include – quitting the habit of smoking, consuming antioxidant-rich foods, avoiding abrasive dental hygiene products (like whiteners and rinses) and attending routine dental exams.

As billing and coding for dental disorders can be complex, relying on dental billing services can be of great help. Reputable providers provide dental billing services by AAPC-certified coding specialists that can help in accurate and timely billing and claims submission.

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