Changes in the ICD-10 CM Diagnostic Codes in 2017

By: Nina Olson, Account Manager and Sales Rep

The dental CDT codes tell the payer (insurance company) what procedure was performed.  The medical counterpart representing procedure codes is the CPT codes.  The ICD-10 CM codes tell WHY the procedure was done and are now being required more and more as dentistry is accepted into the medical field.   For those of you that are resistant to change get over it when it comes to coding.  The CDT Code set has changes coming in 2017 with eleven new codes to wrap your head around.  Now the ICD-10 CM is changing too.   Get ready to purchase the updated books or put a copy of the new code changes in your current book.  Some coding changes from the current September/October 2016 issue of Insurance Solutions Newsletter and the following codes would be most common to the general practice.

New ICD-10 CM codes reporting periodontitis as follows:

K05.2 Aggressive periodontitis (Acute pericoronitis)

K04.4 Acute apical periodontitis, K04.7 periapical abscess, K04.6 periapical abscess with sinus

K05.20 Aggressive periodontitis, unspecified

K05.21 Aggressive periodontitis, localized   (Periodontal abscess)

K05.211 Aggressive periodontitis, localized, slight (new)

K05.212 Aggressive periodontitis, localized, moderate (new)

K05.213 Aggressive periodontitis, localized, severe (new)

K05.219 Aggressive periodontitis, localized unspecified severity (new)

K05.221 Aggressive periodontitis, generalized slight (new)

K05.223 Aggressive periodontitis, generalized severe (new)

K05.229 Aggressive periodontitis, generalized unspecified severity (new)

K04.0 Pulpitis (has two subcategories)

K04.01 Reversible pulpitis (new)

K04.02 Irreversible pulpitis (new)

These new codes are more specific to the variance of the condition.   Since October 2016 additional codes are now being report laterally whereas before they were not.  Codes specific to laterality report right, left, or bilaterally.

Z29.3 Encounter for prophylactic fluoride administration (reporting fluoride application)

eAssist Helpful News and Billing Tips; Edition #106


  • Great Heads Up for the new year.

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