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ICD-10 Codes for Orthodontics, Study notes of Orthodontics

ICD-10 Codes for Orthodontics. Orthodontic exam and evaluation. Pain. Spasmodic torticollis. G24.3. Idiopathic Orofacial dystonia (Orofacial dyskinesia).

Typology: Study notes

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ICD-10 Codes for Orthodontics
IntroductionKirt E. Simmons, DDS, PhD
This document is meant to provide general information on diagnostic coding, specifically coding using
the ICD-10 code set. Proper and accurate diagnostic coding is important to both provide data to third-
party payers and public entities but also to provide proper remuneration for the therapeutic procedures
(CDT or CPT codes) used to address those diagnosed conditions. The World Health Organization
(WHO) website has an online training tool (WHO website link-
http://apps.who.int/classifications/apps/icd/icd10training/) and there are multiple private vendors
offering ICD-10 coding instruction, albeit generally aimed at the larger general medical audience.
This guide is meant to provide a general overview of the ICD-10 codes and how to use them. It is NOT
an exhaustive guide and should not be considered necessarily authoritative or up to date.
How-To Guidelines - Kirt E. Simmons, DDS, PhD
ICD-10 codes consist of a minimum of three characters and a maximum of seven, in the following
order of character: 1) Capital letter A-Z except U (not used), 2) number, 3) number, 4) number or
letter, capital or lowercase, 5) number or letter, capital or lowercase, 6) number or letter, capital or
lowercase, 7) number or letter, capital or lowercase- only used in certain specific cases.
Please refer to the ICD-10 codes the AAO has collected (which will most commonly be used in
the provision of orthodontic services) for the following explanations of the code.
The first character of the code is always a capital letter and denotes the general category or
conditions grouped together by the WHO. Note in the AAO list we have grouped categories
together under a larger heading (i.e. Pain, Larynx) which usually will all have the same first letter
but not necessarily (note the Pain group contains three WHO categories- G- Diseases of the
Nervous System, H- Diseases of the Eye and Adnexa and M- Diseases of the Musculoskeletal
System and Connective Tissue), since we have taken the liberty of grouping various diagnoses
together so they may be more easily located. You will notice the most commonly used diagnoses
for orthodontists will be within the categories M (Diseases of the Musculoskeletal System and
Connective Tissue) and K (Diseases of the Digestive System). There are also a large number of
Q (Congenital Malformations, Deformations, and Chromosomal Abnormalities) and S codes
(Injury, Poisoning, and Certain Other Consequences of External Causes which actually
includes T codes too).
To see how typical codes are displayed, see the ones under “Migraine-- note they all begin with
G43” which generally describes migraines, but then the next numeral, after the “.” further
describes the type of migraine- with a “0” being those without an aura. The following one or two
numerals further describe the specific type of migraine without an aura. Looking at perhaps a
more familiar set of diagnostic conditions we orthodontists are familiar with, let us take the K
codes: K00 K14 are reserved for diseases of the oral cavity and salivary glands. So note the K00
codes all describe disorders of tooth development and eruption (except for “embedded and
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Introduction – Kirt E. Simmons, DDS, PhD

This document is meant to provide general information on diagnostic coding, specifically coding using

the ICD-10 code set. Proper and accurate diagnostic coding is important to both provide data to third-

party payers and public entities but also to provide proper remuneration for the therapeutic procedures

(CDT or CPT codes) used to address those diagnosed conditions. The World Health Organization

(WHO) website has an online training tool (WHO website link-

http://apps.who.int/classifications/apps/icd/icd10training/) and there are multiple private vendors

offering ICD-10 coding instruction, albeit generally aimed at the larger general medical audience.

This guide is meant to provide a general overview of the ICD-10 codes and how to use them. It is NOT

an exhaustive guide and should not be considered necessarily authoritative or up to date.

How-To Guidelines - Kirt E. Simmons, DDS, PhD

  • ICD-10 codes consist of a minimum of three characters and a maximum of seven, in the following

order of character: 1) Capital letter A-Z except U (not used), 2) number, 3) number, 4) number or

letter, capital or lowercase, 5) number or letter, capital or lowercase, 6) number or letter, capital or

lowercase, 7) number or letter, capital or lowercase- only used in certain specific cases.

  • Please refer to the ICD-10 codes the AAO has collected (which will most commonly be used in

the provision of orthodontic services) for the following explanations of the code.

  • The first character of the code is always a capital letter and denotes the general category or

conditions grouped together by the WHO. Note in the AAO list we have grouped categories

together under a larger heading (i.e. Pain, Larynx ) which usually will all have the same first letter

but not necessarily (note the Pain group contains three WHO categories- G- Diseases of the

Nervous System , H- Diseases of the Eye and Adnexa and M- Diseases of the Musculoskeletal

System and Connective Tissue ), since we have taken the liberty of grouping various diagnoses

together so they may be more easily located. You will notice the most commonly used diagnoses

for orthodontists will be within the categories M ( Diseases of the Musculoskeletal System and

Connective Tissue ) and K ( Diseases of the Digestive System ). There are also a large number of

Q ( Congenital Malformations, Deformations, and Chromosomal Abnormalities ) and S codes

( Injury, Poisoning, and Certain Other Consequences of External Causes – which actually

includes T codes too).

  • To see how typical codes are displayed, see the ones under “ Migraine ”-- note they all begin with

“ G43 ” which generally describes migraines, but then the next numeral, after the “. ” further

describes the type of migraine- with a “ 0 ” being those without an aura. The following one or two

numerals further describe the specific type of migraine without an aura. Looking at perhaps a

more familiar set of diagnostic conditions we orthodontists are familiar with, let us take the K

codes: K00 – K14 are reserved for diseases of the oral cavity and salivary glands. So note the K

codes all describe disorders of tooth development and eruption (except for “embedded and

impacted teeth” which are K01 ), while the K02 codes describe caries, with the numerals after the

“.” defining first the location with the second numeral the extent of the caries.

  • For orthodontics, the M26 ( Anomalies of dental relationship ) codes will almost universally be

used on every one of our patients, since they encompass all the forms of “malocclusion”. It is

important when coding to specify, as closely as possible, the patient’s situation – that is it is not

appropriate to simply code all one’s patients as M26.20 (Unspecified anomaly of dental arch

relationship) or M26.4 (Malocclusion, unspecified). These codes are only to be used if either none

of the other codes are appropriate or, due to the circumstances, one cannot determine the more

specific category.

  • Also, when coding, it is important to list ALL codes relevant to the accompanying procedure,

with the most “significant” code(s) listed first. For instance, if one were going to bill for the

comprehensive orthodontic treatment of a Class II anterior openbite patient with an impacted

canine, crowding and midlines off one would code M26.212, M26.220, K00.6, M26.31, and

M26.29. As you can see from this example, although the CDT Procedure Code for this case

would be simply D8080 (in the adolescent dentition) this would clearly be a more challenging

case than one coded simply M26.212 without the other orthodontic issues. Also, any interested

third parties could clearly glean more information from these diagnostic codes compared to what

could be obtained from the Procedure codes.

As the ICD-10 codes are continuously updated the AAO will endeavor to keep this list current, so it is

wise to consult this code list at least periodically. The AAO has also endeavored to provide staff support

for ICD-10 implementation coding by members, who may contact Ann Sebaugh at 314-993-1700, ext. 582

or 1-800-424-2841 or at asebaugh@aaortho.org.

Larynx

Anomalies of jaw-cranial base relationship

Diseases of Oral Cavity and Sinuses

Dentofacial Anomalies

  • Spasmodic torticollis G24. Pain
  • Idiopathic Orofacial dystonia (Orofacial dyskinesia) G24.
  • Vascular headache, not elsewhere classified G44.
  • Tension-type headache, unspecified, intractable G44.
  • Tension-type headache, unspec., not intractable G44.2Ø
  • Episodic tension-type headache, intractable G44.
  • Episodic tension-type headache, not intractable G44.
  • Chronic tension-type headache, intractable G44.
  • Chronic tension-type headache, not intractable G44.
  • Trigeminal neuralgia G50.
  • Atypical face pain G50.
  • Ocular pain, unspecified eye H57.
  • Ocular pain, right eye H57.
  • Ocular pain, left eye H57.
  • Ocular pain, bilateral H57.
  • Arthralgia of the temporomandibular joint M26.
  • Cervicalgia M54.
  • Myalgia M79.
  • Neuralgia and neuritis, unspecified M79.
  • Migraine without aura, not intractable, with status migrainosus G43. (always check with patient’s primary care provider for which migraine code applies)
  • Migraine without aura, not intractable, without status migrainosus G43.
  • Migraine without aura, intractable, with status migrainosus G43.
  • Migraine without aura, intractable, without status migrainosus G43.Ø
  • Migraine with aura, not intractable, with status migrainosus G43.
  • Migraine with aura, not intractable, without status migrainosus G43.
  • Migraine with aura, not intractable, with status migrainosus G43.
  • Migraine with aura, intractable, without status migrainosus G43.
  • Chronic migraine without aura, not intractable, with status migrainosus G43.
  • Chronic migraine without aura, not intractable, without status migrainosus G43.
  • Other migraine, not intractable, with status migrainosus G43.
  • Other migraine, not intractable, without status migrainosus G43.
  • Other migraine, intractable, with status migrainosus G43.
  • Other migraine, intractable, without status migrainosus G43.
  • Vascular headache, not elsewhere classified G44.
    • Encounter for other specified special examinations Z01.
  • Sleep Apnea, unspecified G47. Sleep Apnea
  • Primary central sleep apnea G47.
  • Obstructive sleep apnea G47.
  • Idiopathic sleep related nonobstructive alveolar hypoventilation G47.
  • Congenital central alveolar hypoventilation Syndrome G47.
  • Other sleep apnea G47.
  • Sleep related bruxism G47.
  • Other sleep disorders G47.
  • Sleep disorder, unspecified G47.
  • Other disorders of trigeminal nerve G50. Nerve Disorders
  • Disorder of trigeminal nerve, unspecified G50.
  • Other disorders of facial nerve G51.
  • Disorder of facial nerve, unspecified G51.
  • Disorders of glossopharyngeal nerve G52.
  • Otalgia, right ear H92. Disorders of the Ears
  • Otalgia, left ear H92.
  • Otalgia, bilateral H92.
  • Otalgia, unspecified ear H92.Ø
  • Tinnitus, right ear H93.
  • Tinnitus, left ear H93.
  • Tinnitus, bilateral H93.
  • Tinnitus, unspecified ear H93.
  • Maxillary asymmetry M26. Unspecified anomaly of jaw-cranial base relationship M26.1Ø
  • Other jaw asymmetry M26.
  • Other specified anomalies of jaw-cranial base relationship M26.
    • Laryngeal spasm J38.
    • Unspecified anomaly of dental arch relationship M26. Anomalies of dental arch relationship
    • Malocclusion, Angle’s class I M26.
    • Malocclusion, Angle’s class II M26.
    • Malocclusion, Angle’s class III M26.
  • Malocclusion, Angle’s class, unspecified M26.
    • Open anterior occlusal relationship (anterior openbite) M26.
    • Open posterior occlusal relationship (posterior openbite) M26.
    • Excessive horizontal overlap (overjet) M26.
    • Reverse articulation, crossbite (anterior or posterior) M26.
    • Anomalies of interarch distance M26.
    • deep, horizontal, or vertical Posterior lingual occlusion of mand. teeth M26. Other anomalies of dental arch relationship Midline deviation of dental arch Overbite (excessive)
    • Unspecified anomaly of tooth position of fully erupted tooth or teeth M26. Anomalies of tooth position
    • Crowding of fully erupted teeth M26.
    • Excessive spacing of fully erupted teeth (diastema) M26.
    • Horizontal displacement of fully erupted tooth or teeth M26.
    • Vertical displacement of fully erupted tooth or teeth M26.
    • Rotation of fully erupted tooth or teeth M26.
    • Insufficient interocclusal distance of fully erupted teeth (ridge) M26.
    • Excessive interocclusal distance of fully erupted teeth M26.
    • Other anomalies of tooth position of fully erupted tooth or teeth M26.
    • Congenital malformation of face and neck, unspecified Q18. Other congenital malformations of skull and face bones
    • Cleft hard palate Q35.
    • Cleft soft palate Q35.
    • Cleft hard palate with cleft soft palate Q35.
    • Cleft palate, unspecified Q35.
    • Cleft hard palate with bilateral cleft lip Q37.
    • Cleft hard palate with unilateral cleft lip Q37.
    • Cleft soft palate with bilateral cleft lip Q37.
    • Cleft soft palate with unilateral cleft lip Q37.
    • Cleft hard and soft palate with bilateral cleft lip Q37.
    • Cleft hard and soft palate with unilateral cleft lip Q37.
    • Unspecified cleft palate with bilateral cleft lip Q37.
    • Unspecified cleft palate with unilateral cleft lip Q37.
    • Congenital malformations of palate, not elsewhere classified Q38.
    • Other congenital malformations of mouth Q38.
    • Other congenital deformities of skull, face, and jaw Q67.
    • Cleidocranial dysostosis/Oculoauricular Dysplasia/OAV Q74.
    • Craniosynostosis, Pierre Robin Sequence Q75.
    • Craniofacial dysostosis Q75.
    • Hypertelorism Q75.
  • Anodontia (missing teeth) K00.
  • Hyperdontia (supernumerary teeth) K00.
  • Abnormalities of size and form K00.
  • Mottled teeth K00.
  • Disturbances of tooth formation K00.
  • Hereditary disturbances in tooth structure, not elsewhere classified K00.
  • Disturbance of tooth eruption K00.
  • Other specified disorder of tooth development and eruption K00.
  • Unspecified disorder of tooth development and eruption K00.
  • Dental caries on pit and fissure surface limited to enamel K02.
  • Dental caries on pit and fissure surface penetrating into dentin K02.
  • Dental caries on pit and fissure surface penetrating into pulp K02.
  • Dental caries on smooth surface limited to enamel K02.
  • Dental caries on smooth surface penetrating into dentin K02.
  • Dental caries on smooth surface penetrating into pulp K02.
  • Dental root caries K02.
  • Dental caries, unspecified K02.
  • Ankylosis of teeth K03.
  • Hypercementosis K03.
  • Ankylosis of teeth K03.
  • Other specified diseases of hard tissues of teeth K03.
  • Acute gingivitis, plaque induced K05.
  • Acute gingivitis, non-plaque induced K05.
  • Chronic gingivitis, plaque induced K05.
  • Chronic gingivitis, non-plaque induced K05.
  • Aggressive gingivitis, plaque induced K05.
  • Aggressive gingivitis, non-plaque induced K05.
  • Aggressive gingivitis, generalized K05.
  • Chronic periodontitis, unspecified K05.
  • Chronic periodontitis, localized K05.
  • Chronic periodontitis, generalized K05.
  • Periodontitis, juvenile periodontitis K05.
  • Other periodontal diseases K05.
  • Periodontal diseases, unspecified K05.
  • Gingival recession K06.
  • Gingival enlargement K06.
  • Disorder of gingiva and edentulous alveolar ridge, unspecified K06.
  • Exfoliation of teeth due to systemic causes K08. Loss of Teeth
  • Partial loss of teeth, unspecified cause, class I K08.
  • Partial loss of teeth, unspecified cause, class II K08.
  • Partial loss of teeth, unspecified cause, class III K08.
  • Partial loss of teeth, unspecified cause, class IV K08.
  • Partial loss of teeth, unspecified cause, unspecified class K08.
  • Partial loss of teeth, due to trauma, class I K08.
  • Partial loss of teeth, due to trauma, class II K08.
  • Partial loss of teeth, due to trauma, class III K08.
  • Partial loss of teeth, due to trauma, class IV K08.
  • Partial loss of teeth, due to trauma, unspecified class K08.
  • Partial loss of teeth, due to periodontal disease, class I K08.
  • Partial loss of teeth, due to periodontal disease, class II K08.
  • Partial loss of teeth, due to periodontal disease, class III K08.
  • Partial loss of teeth, due to periodontal disease, Class IV K08.
  • Partial loss of teeth, due to periodontal disease, Unspecified class K08.
  • Partial loss of teeth, due to caries, class I K08.
  • Partial loss of teeth, due to caries, class II K08.
  • Partial loss of teeth, due to caries, class III K08.
  • Partial loss of teeth, due to caries, class IV K08.
  • Partial loss of teeth, due to caries, unspecified class K08.
  • Unspecified anomaly of jaw size M26. Major anomalies of jaw size
  • Maxillary hyperplasia M26.
  • Maxillary hypoplasia M26.
  • Mandibular hyperplasia M26.
  • Mandibular hypoplasia M26.
  • Macrogenia M26.
  • Microgenia M26.
  • Excessive tuberosity of jaw (entire maxillary tuberosity) M26.
  • Other specified anomalies of jaw size M26.
  • Dentofacial functional abnormalities, unspecified M26. Dentofacial functional abnormalities
  • Abnormal jaw closure M26.
  • Limited mandibular range of motion M26.
  • Deviation in opening and closing mandible M26.
  • Insufficient anterior guidance M26.
  • Centric occlusion maximum intercuspation discrepancy M26.
  • Non-working side interference M26.
  • Lack of posterior occlusal support M26.
  • Other dentofacial functional abnormalities M26.
  • Temporomandibular joint disorder, unspecified M26. Temporomandibular joint disorders
  • Adhesions and ankylosis of temporomandibular joint M26.
  • Arthralgia of temporomandibular joint M26.
  • Articular disc disorder of temporomandibular joint M26.
  • Other specified disorders of temporomandibular joint M26.

S02 Codes below are listed with A, but use the letters above when applicable

Fracture of nasal bones, initial encounter for closed fracture S02.2XXA Fracture of nasal bones, initial encounter for open fracture S02.2XXB Malar fracture unspecified, initial encounter for closed fracture S02.400A Malar fracture, unspecified, initial encounter for open fracture S02.400B Maxillary fracture, unspecified, initial encounter for closed fracture S02.401A

Maxillary fracture, unspecified, initial encounter for open fracture S02.401B Fracture of zygoma bones, unspecified, initial encounter for closed fracture S02.402A Fracture of zygoma bones, unspecified, initial encounter for open fracture S02.402B LaForte I fracture, initial encounter for closed fracture S02.411A LaForte I fracture, initial encounter for open fracture S02.411B

LaForte II fracture, initial encounter for closed fracture S02.412A LaForte II fracture, initial encounter for open fracture S02.412B LaForte III fracture, initial encounter for closed fracture S02.413A LaForte III fracture, initial encounter for open fracture S02.413B Fracture of alveolus of maxilla, initial encounter for closed fracture S02.42XA

Fracture of alveolus of maxilla, initial encounter for open fracture S02.42XB Fracture of unspecified part of body of mandible, initial encounter, closed S02.600A Fracture of unspecified part of body of mandible, initial encounter, open S02.600B Fracture of mandible, unspecified, initial encounter, closed S02.609A Fracture of mandible, unspecified, initial encounter, open S02.609B

Fracture of condylar process of mandible, initial encounter for closed fracture S02.61XA Fracture of condylar process of mandible, initial encounter for open fracture S02.61XB Fracture of subcondylar process of mandible, initial encounter for closed fracture S02.62XA Fracture of subcondylar process of mandible, initial encounter for open fracture S02.62XB Fracture of coronoid process of mandible, initial encounter for closed fracture S02.63XA

Fracture of coronoid process of mandible, initial encounter for open fracture S02.63XB Fracture of ramus of mandible, initial encounter for closed fracture S02.64XA Fracture of ramus of mandible, initial encounter for open fracture S02.64XB Fracture of angle of mandible, initial encounter for closed fracture S02.65XA

Fracture of angle of mandible, initial encounter for open fracture S02.65XB Fracture of symphysis of mandible, initial encounter for closed fracture S02.66XA Fracture of symphysis of mandible, initial encounter for open fracture S02.66XB Fracture of alveolus of mandible, initial encounter for closed fracture S02.67XA Fracture of alveolus of mandible, initial encounter for open fracture S02.67XB

Fracture of mandible of other specified site, initial encounter for open fracture S02.69XB Fracture of other specified skull bones, initial encounter for closed fracture S02.8XXA Fracture of other specified skull bones, initial encounter for open fracture S02.8XXB Fracture of unspecified skull and facial bones, initial encounter, closed S02.91XA Fracture of unspecified skull and facial bones, initial encounter, open S02.91XB

Fractures (If codes have less than 5 digits, follow with an x as a placeholder. A is shown in the codes below for initial encounter, otherwise use D for subsequent encounter, S for sequela when applicable, G for subsequent encounter for fracture with delayed healing, K for subsequent encounter with nonunion) (follow example of dislocation of jaw codes below) (A fracture not indicated in the patient record as open or closed should be coded to closed)

Unspecified fracture of facial bones, initial encounter, closed S02.92XA Unspecified fracture of facial bones, initial encounter, open S02.92XB