Top ICD-10 Codes For Dental Conditions In Elderly Patients

Geriatric health problems expose elderly patients at risk to dental issues, due to difficulty to maintain oral hygiene. In elderly patients, poor dental care or eating habits, inadequate dental nutrition and medications cause oral health conditions, which result in inflammation and bleeding in gums, gum infections, tooth pain and tooth decay. Early identification of such oral health conditions help in treatment. Claim submission of dental conditions in elderly patients is challenging. Dentists and dental billing companies should be up to date with updated medical codes and insurance companies' guidelines for accurate claim submission.

Common dental conditions affecting elderly patients are:

1. Tooth Decay:

Tooth decay create cavity in the tooth causing permanent damage to hard surface of teeth developing into tiny openings. It is also known as dental caries. It is caused by combination of factors, like sugary drinks, bacteria in the mouth, frequent snacking, and not cleaning the teeth well. Signs and symptoms of tooth decay vary depending on the location and extend of cavities. In beginning, it may be asymptomatic, but as condition worsens, it causes symptoms like , toothache, tooth sensitivity, pain when biting, staining on surface of tooth and visible holes or pits in the teeth. Tooth decay cause pain, infection, or tooth loss in extreme cases. Treatment options are fillings (restorations), tooth extraction, root canals, crowns and fluoride treatments.

ICD – 10 codes for tooth decay are:

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

2. Dry Mouth (Xerostomia):

In dry mouth, salivary glands in the mouth don’t produce adequate saliva to keep the mouth wet. In majority of cases, it is due to geriatric issues affecting salivary glands, side effect of certain medications, radiation therapy for cancer, nerve damage and tobacco or alcohol use. Symptoms are thick and stringy saliva, dry or sore throat and hoarseness, bad breath, difficulty in chewing, speaking and swallowing and dry or grooved tongue and dryness or a feeling of stickiness in the mouth, Medications for moisturization of mouth, stimulation of saliva saliva and protection the teeth are suggested.

ICD – code for dry mouth is:

R68.2 Dry mouth, unspecified

3. Receding Gums:

In this condition, gums recede or wear away, exposing the pink tissue that covers the root of the teeth, forming gaps between the gum and tooth, allowing bacteria build up. Main causes are poor oral health, and age factor. Other causes are periodontal or gum disease, poor oral hygiene, aggressive brushing over the long term, hardened plaque buildup (tartar), use of any tobacco products, diabetes, crooked teeth, unfit bridges or partial dentures, medications causing dry mouth and specific immune disorders. Mostly, it is asymptomatic at an early stage. Later, patients may experience pain and swelling in gums, bad breath, loose and exposed tooth roots and bleeding after brushing/ flossing. Diagnosis arrived by physical examination. Initially combination of medications and other procedures like, scaling and root planning and composite restoration suggested. In advanced stages, flap surgery and grafting suggested.

ICD-10 codes for gum recession are:

K06.0 Gingival recession

K06.01 Gingival recession, localized

  • K06.010 Localized gingival recession, unspecified

  • K06.011 Localized gingival recession, minimal

  • K06.012 Localized gingival recession, moderate

  • K06.013 Localized gingival recession, severe

K06.02 Gingival recession, generalized

  • K06.020 Generalized gingival recession, unspecified

  • K06.021 Generalized gingival recession, minimal

  • K06.022 Generalized gingival recession, moderate

  • K06.023 Generalized gingival recession, severe

4. Gum Disease (Periodontitis):

It is a severe gum infection damaging soft tissue and bone supporting teeth, occurs due to poor brushing and flossing habits causing plaque build up around the tooth, resulting in inflammation of the gums, redness, swelling and bleeding while brushing, loosen tooth and finally tooth loss. Symptoms are swollen gums, pus between the teeth and gums, bad breath, bleeding gums, and painful chewing.

ICD-10 codes for gum disease are:

K05 Gingivitis and periodontal diseases

  • K05.2 Aggressive periodontitis

  • K05.3 Chronic periodontitis

  • K05.4 Periodontosis

  • K05.5 Other periodontal diseases

  • K05.6 Periodontal disease, unspecified

5. Oral Cancer:

Symptoms in oral cancer are pain and tenderness in the teeth or gums, mouth sores or ulcers, red or white patches in mouth, change in mouth tissue, swelling or fullness in neck, loose teeth and painful swallowing.

ICD-10 codes for oral cancer are:

C00 Malignant neoplasm of lip

  • C01 Malignant neoplasm of base of tongue

  • C02 Malignant neoplasm of other and unspecified parts of tongue

  • C03 Malignant neoplasm of gum

  • C04 Malignant neoplasm of floor of mouth

  • C05 Malignant neoplasm of palate

  • C06 Malignant neoplasm of other and unspecified parts of mouth

  • C07 Malignant neoplasm of parotid gland

  • C08 Malignant neoplasm of other and unspecified major salivary glands

  • C09 Malignant neoplasm of tonsil

  • C10 Malignant neoplasm of oropharynx

  • C11 Malignant neoplasm of nasopharynx

  • C12 Malignant neoplasm of pyriform sinus

  • C13 Malignant neoplasm of hypopharynx

  • C14 Malignant neoplasm of other and ill-defined sites in the lip, oral cavity and pharynx


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