Locating a Diagnosis Code in ICD-10-CM for Dental Offices

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Sep 23rd, 2020

Diagnosis codes used to report with procedures are called ICD-10-CM - International Statistical Classification of Diseases. These codes are published annually in October. To find a diagnosis code in ICD-10-CM, it is important to understand how the chapters and sections are set up. Each chapter is broken down into sections and sections are further broken down to the most specific code.

• A diagnosis code can be anywhere from 3 to 7 characters.  
• You must always use the most specific code applicable to the condition.
• A Red flag indicates either a NON-Specific code or an incomplete code.  (Keep looking)

Diagnosis codes are set up in chapters and sections as shown below.

Each section is further broken down by anatomy or condition. For example, dental caries are found in diseases of the digestive system, as the mouth is a part of the digestive system in ICD-10-CM. The example below shows where it is found in Chapter 11 with the code ranges K00-K95.

You don't need the entire code set
For a dental practice adding medical billing, there are only a few chapters that may pertain to your practice such as the examples below. This is not all-inclusive, but these are the chapters where you will spend the most time for a dental practice. 

• Chapter 4.  E08-E13 Diabetes mellitus
  Chapter 11. K00-K14 Diseases of oral cavity and salivary glands
  Chapter 13. M00-M99, Diseases of the musculoskeletal system and connective tissue
  Chapter 17. Q38, Other congenital malformations of tongue, mouth and pharynx
  Chapter 18. R00-R99, Symptoms, signs, and abnormal clinical and lab findings, not elsewhere classified
  Chapter 19. S02, Fracture of skull and facial bones
  Chapter 20. V00-Y99, External causes of morbidity