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Loss of Teeth F054
In this section
Current RMA Instruments:
|Reasonable Hypothesis SOP||124 of 2015|
|Balance of Probabilities SOP||125 of 2015|
Changes from previous Instruments:
- ICD-9-CM Codes: 525.1, 525.3
- ICD-10-AM Codes: K08.1, K08.3
Confirming the diagnosis
Confirmation of tooth loss requires a dental/medical report or dental records that identifies the affected tooth/teeth. The tooth or teeth affected should be specified in the diagnostic label used.
Additional diagnoses covered by SOP
- Surgical extraction of tooth
Conditions not covered by SOP
- Dental caries, ICD code 525.0
- Dental pulp disease, ICD codes 522.0, 522.1, 522.2, 522.5, 522.7, 522.9
- Periodontitis, ICD codes 522.4, 522.6, 523.3-523.5
Each loss of a tooth, or of a group of teeth at one time from one cause, represents a separate clinical onset. Clinical onset will be when the tooth/teeth came out rather than when a disease or injury that led to subsequent tooth loss occurred.
The only SOP worsening factor is for inability to obtain appropriate clinical management. Any later consequences following loss of a tooth or teeth would represent a new condition rather than a permanent worsening of loss of teeth.