ICD-10 Coding for Dental Decay(K02.51, K02.1, K02.7)
Complete ICD-10-CM coding and documentation guide for Dental Decay. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Dental Decay
K02Primary Range
Dental caries
This range includes all codes related to dental caries, covering various stages and locations of decay.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K02.51 | Dental caries on pit and fissure surface limited to enamel | Use when caries are confined to the enamel of pit and fissure surfaces. |
|
| K02.1 | Dental caries of dentine | Use when caries extend into the dentine. |
|
| K02.7 | Dental root caries | Use when caries are present on the root surface. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for dental decay
Essential facts and insights about Dental Decay
Primary ICD-10-CM Codes for dental decay
Decision Criteria
clinical Criteria
- Caries limited to enamel with no dentine involvement.
Applicable To
- Pit and fissure caries limited to enamel
Excludes
- Dentine caries (K02.1)
Clinical Validation Requirements
- Visible enamel demineralization in occlusal grooves
Code-Specific Risks
- Misidentifying the depth of caries can lead to incorrect coding.
Coding Notes
- Ensure the caries are limited to enamel before using this code.
K02.1 - Dental caries of dentine
Use when caries extend into the dentine.
Applicable To
- Dentine caries
Excludes
- Enamel caries (K02.51)
Clinical Validation Requirements
- Radiographic evidence of dentine involvement
Coding Notes
Document radiographic findings clearly to support this code.
K02.7 - Dental root caries
Use when caries are present on the root surface.
Applicable To
- Root caries
Excludes
- Caries of crown (K02.1, K02.51)
Clinical Validation Requirements
- Visible CEJ defect with recession
Coding Notes
Ensure documentation of root involvement and recession.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Dental Decay to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K02.51.
Impact
Clinical: May lead to inappropriate treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Always include radiographic evidence in patient records., Train staff on proper documentation practices.
Impact
Reimbursement: May lead to lower reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of health records.
Mitigation Strategy
Ensure detailed documentation of caries location and depth to use specific codes.
Impact
Inadequate documentation of risk factors can lead to audit issues.
Mitigation Strategy
Implement standardized templates for documenting risk assessments.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Dental Decay, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Dental Decay
Use these documentation templates to ensure complete and accurate documentation for Dental Decay. These templates include all required elements for proper coding and billing.
Caries Risk Assessment
Specialty: DentistryRequired Elements
- Salivary flow rate
- Visible plaque
- Dietary habits
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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