ICD-10 Codes for Dental Caries – A Common Dental Condition

Author : Outsource Strategies International | Published On : 23 Sep 2021

Regarded as the most common dental problem, dental caries is the permanent destruction of tooth enamel. Also called tooth decay, the condition is caused by a specific, sticky film of bacteria called plaque that forms on the teeth and leads to tiny openings or holes. The condition can affect the teeth at any age, though it is most common among children and young adults. If left untreated, the condition can get larger and affect the deeper layers of the teeth causing toothache, infection and tooth loss. Regular dental visits and good brushing and flossing habits can help protect the teeth against cavities and tooth decay. Practices must be up to date with the latest medical codes and perform dental eligibility verification to ensure proper billing and accurate claim submission.

Although dental caries are largely preventable, they remain the most common chronic disease affecting children aged 6 -11 years and adolescents aged 12-19 years. In fact, tooth decay is four times more common than asthma among adolescents aged 14-17 years. It also affects adults, with 9 out of 10 over the age of 20 having some degree of tooth-root decay. Dental caries is caused by a combination of factors, such as frequent unhealthy snacking habits, sipping sugary drinks, inadequate brushing, and tooth fracture or abscess. Other factors that can increase the risk of tooth decay include not getting enough fluoride, worn fillings or dental devices, bedtime infant feeding, and certain infant disorders. 

Symptoms, Diagnosis and Treatment 

Generally, the early stage of dental caries may not show any signs or symptoms. However, as the tooth decay worsens, certain signs and symptoms like toothache (spontaneous pain or pain that occurs without any apparent cause), tooth sensitivity, visible holes or pits in your teeth, mild to sharp pain (when eating or drinking something sweet, hot or cold), pain when biting and brown, black or white staining on any surface of a tooth may occur. 

Diagnosis of tooth decay involves enquiring about tooth pain and sensitivity, examining mouth and teeth and probing teeth with dental instruments to check for soft areas. These detailed exam will help analyze the type of cavity –smooth surface, pit and fissure, or root. Dental x-rays may be performed to analyze the extent of cavities and decay. Treatment modalities for dental caries depend on the type and severity of the condition. Treatment options include – fluoride treatments, fillings, root canals, crowns and tooth extractions. 

ICD-10 Codes for Dental Caries 

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 oral and dental hygiene and reducing the activities that damage or stress the mouth lining can help avoid cavities and tooth decay. Make a habit to brush the teeth twice daily with fluoride toothpaste. Eating a healthy, balanced diet and getting regular professional dental cleanings as recommended by the dentist. Other prevention strategies include – flossing the teeth daily, 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. 

Billing and coding for dental conditions and dental eligibility verification can be complex. Companies offering medical billing services in USA also offer dental billing. Partnering with an experienced company is the best way for dental practices to ensure correct and timely medical billing and claims submission.