Avulsion and subsequent replantation of a tooth

Current RMA Instruments

Reasonable Hypothesis SOP	29 of 2025
Balance of Probabilities SOP	30 of 2025

Changes from previous Intruments

ICD Coding

ICD-10-AM Codes: K08.1, K08.3, S02.5

Brief Description

Tooth loss means partial or complete permanent loss of a natural adult tooth. Adult teeth, also called permanent or secondary teeth, usually replace baby teeth between the ages of 6 and 12 years old. Wisdom teeth, which are also part of the adult set, usually come in between ages 17 and 21 years old. Sometimes, when a tooth is lost, part of the root of the tooth that sits in the jawbone may still remain. This SOP covers tooth loss with or without retained dental root.

Confirming the diagnosis

Confirmation of tooth loss requires dental or medical records that identifies the affected tooth or teeth.

The tooth or teeth affected should be specified in the diagnostic label used.

Additional diagnoses covered by SOP

Fracture of tooth
Tooth Loss due to surgical extraction

Conditions not covered by SOP

Dental caries* - Tooth decay (dental caries) SOP
Dental pulp disease* - Dental pulp and periapical disease SOP
Periodontitis* - Periodontitis SOP
Tooth wear* - Tooth wear SOP
Superficial tooth wear confined to the enamel - Not a disease

*another SOP applies

#non-SOP condition

Clinical onset

Clinical onset is when the partial or complete loss of a tooth or teeth occurred. In some cases, the date of the injury or disease that led to the tooth loss may differ from the actual date of tooth loss and should not be used as the clinical onset date. Each instance of tooth loss- or loss of a group of teeth resulting from a single cause- should be regarded as a separate clinical onset.

Clinical worsening

The only worsening factor is inability to obtain appropriate clinical management. The loss of an additional tooth or group of teeth should be considered a new condition and diagnosed separately. Similarly, if a disease develops as a result of the tooth loss, it should be treated as a new condition- not as a clinical worsening of the original tooth loss.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/loss-teeth-f054-k081k083/rulebase-loss-teeth/avulsion-and-subsequent-replantation-tooth

Dental caries

Current RMA Instruments

Reasonable Hypothesis SOP	29 of 2025
Balance of Probabilities SOP	30 of 2025

Changes from previous Intruments

ICD Coding

ICD-10-AM Codes: K08.1, K08.3, S02.5

Brief Description

Tooth loss means partial or complete permanent loss of a natural adult tooth. Adult teeth, also called permanent or secondary teeth, usually replace baby teeth between the ages of 6 and 12 years old. Wisdom teeth, which are also part of the adult set, usually come in between ages 17 and 21 years old. Sometimes, when a tooth is lost, part of the root of the tooth that sits in the jawbone may still remain. This SOP covers tooth loss with or without retained dental root.

Confirming the diagnosis

Confirmation of tooth loss requires dental or medical records that identifies the affected tooth or teeth.

The tooth or teeth affected should be specified in the diagnostic label used.

Additional diagnoses covered by SOP

Fracture of tooth
Tooth Loss due to surgical extraction

Conditions not covered by SOP

Dental caries* - Tooth decay (dental caries) SOP
Dental pulp disease* - Dental pulp and periapical disease SOP
Periodontitis* - Periodontitis SOP
Tooth wear* - Tooth wear SOP
Superficial tooth wear confined to the enamel - Not a disease

*another SOP applies

#non-SOP condition

Clinical onset

Clinical onset is when the partial or complete loss of a tooth or teeth occurred. In some cases, the date of the injury or disease that led to the tooth loss may differ from the actual date of tooth loss and should not be used as the clinical onset date. Each instance of tooth loss- or loss of a group of teeth resulting from a single cause- should be regarded as a separate clinical onset.

Clinical worsening

The only worsening factor is inability to obtain appropriate clinical management. The loss of an additional tooth or group of teeth should be considered a new condition and diagnosed separately. Similarly, if a disease develops as a result of the tooth loss, it should be treated as a new condition- not as a clinical worsening of the original tooth loss.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/loss-teeth-f054-k081k083/rulebase-loss-teeth/dental-caries

Dental pulp disease

Current RMA Instruments

Reasonable Hypothesis SOP	29 of 2025
Balance of Probabilities SOP	30 of 2025

Changes from previous Intruments

ICD Coding

ICD-10-AM Codes: K08.1, K08.3, S02.5

Brief Description

Tooth loss means partial or complete permanent loss of a natural adult tooth. Adult teeth, also called permanent or secondary teeth, usually replace baby teeth between the ages of 6 and 12 years old. Wisdom teeth, which are also part of the adult set, usually come in between ages 17 and 21 years old. Sometimes, when a tooth is lost, part of the root of the tooth that sits in the jawbone may still remain. This SOP covers tooth loss with or without retained dental root.

Confirming the diagnosis

Confirmation of tooth loss requires dental or medical records that identifies the affected tooth or teeth.

The tooth or teeth affected should be specified in the diagnostic label used.

Additional diagnoses covered by SOP

Fracture of tooth
Tooth Loss due to surgical extraction

Conditions not covered by SOP

Dental caries* - Tooth decay (dental caries) SOP
Dental pulp disease* - Dental pulp and periapical disease SOP
Periodontitis* - Periodontitis SOP
Tooth wear* - Tooth wear SOP
Superficial tooth wear confined to the enamel - Not a disease

*another SOP applies

#non-SOP condition

Clinical onset

Clinical onset is when the partial or complete loss of a tooth or teeth occurred. In some cases, the date of the injury or disease that led to the tooth loss may differ from the actual date of tooth loss and should not be used as the clinical onset date. Each instance of tooth loss- or loss of a group of teeth resulting from a single cause- should be regarded as a separate clinical onset.

Clinical worsening

The only worsening factor is inability to obtain appropriate clinical management. The loss of an additional tooth or group of teeth should be considered a new condition and diagnosed separately. Similarly, if a disease develops as a result of the tooth loss, it should be treated as a new condition- not as a clinical worsening of the original tooth loss.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/loss-teeth-f054-k081k083/rulebase-loss-teeth/dental-pulp-disease

Direct physical trauma resulting in avulsion of the tooth

Current RMA Instruments

Reasonable Hypothesis SOP	29 of 2025
Balance of Probabilities SOP	30 of 2025

Changes from previous Intruments

ICD Coding

ICD-10-AM Codes: K08.1, K08.3, S02.5

Brief Description

Tooth loss means partial or complete permanent loss of a natural adult tooth. Adult teeth, also called permanent or secondary teeth, usually replace baby teeth between the ages of 6 and 12 years old. Wisdom teeth, which are also part of the adult set, usually come in between ages 17 and 21 years old. Sometimes, when a tooth is lost, part of the root of the tooth that sits in the jawbone may still remain. This SOP covers tooth loss with or without retained dental root.

Confirming the diagnosis

Confirmation of tooth loss requires dental or medical records that identifies the affected tooth or teeth.

The tooth or teeth affected should be specified in the diagnostic label used.

Additional diagnoses covered by SOP

Fracture of tooth
Tooth Loss due to surgical extraction

Conditions not covered by SOP

Dental caries* - Tooth decay (dental caries) SOP
Dental pulp disease* - Dental pulp and periapical disease SOP
Periodontitis* - Periodontitis SOP
Tooth wear* - Tooth wear SOP
Superficial tooth wear confined to the enamel - Not a disease

*another SOP applies

#non-SOP condition

Clinical onset

Clinical onset is when the partial or complete loss of a tooth or teeth occurred. In some cases, the date of the injury or disease that led to the tooth loss may differ from the actual date of tooth loss and should not be used as the clinical onset date. Each instance of tooth loss- or loss of a group of teeth resulting from a single cause- should be regarded as a separate clinical onset.

Clinical worsening

The only worsening factor is inability to obtain appropriate clinical management. The loss of an additional tooth or group of teeth should be considered a new condition and diagnosed separately. Similarly, if a disease develops as a result of the tooth loss, it should be treated as a new condition- not as a clinical worsening of the original tooth loss.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/loss-teeth-f054-k081k083/rulebase-loss-teeth/direct-physical-trauma-resulting-avulsion-tooth

Fracture or disruption of the alveolar bone

Current RMA Instruments

Reasonable Hypothesis SOP	29 of 2025
Balance of Probabilities SOP	30 of 2025

Changes from previous Intruments

ICD Coding

ICD-10-AM Codes: K08.1, K08.3, S02.5

Brief Description

Tooth loss means partial or complete permanent loss of a natural adult tooth. Adult teeth, also called permanent or secondary teeth, usually replace baby teeth between the ages of 6 and 12 years old. Wisdom teeth, which are also part of the adult set, usually come in between ages 17 and 21 years old. Sometimes, when a tooth is lost, part of the root of the tooth that sits in the jawbone may still remain. This SOP covers tooth loss with or without retained dental root.

Confirming the diagnosis

Confirmation of tooth loss requires dental or medical records that identifies the affected tooth or teeth.

The tooth or teeth affected should be specified in the diagnostic label used.

Additional diagnoses covered by SOP

Fracture of tooth
Tooth Loss due to surgical extraction

Conditions not covered by SOP

Dental caries* - Tooth decay (dental caries) SOP
Dental pulp disease* - Dental pulp and periapical disease SOP
Periodontitis* - Periodontitis SOP
Tooth wear* - Tooth wear SOP
Superficial tooth wear confined to the enamel - Not a disease

*another SOP applies

#non-SOP condition

Clinical onset

Clinical onset is when the partial or complete loss of a tooth or teeth occurred. In some cases, the date of the injury or disease that led to the tooth loss may differ from the actual date of tooth loss and should not be used as the clinical onset date. Each instance of tooth loss- or loss of a group of teeth resulting from a single cause- should be regarded as a separate clinical onset.

Clinical worsening

The only worsening factor is inability to obtain appropriate clinical management. The loss of an additional tooth or group of teeth should be considered a new condition and diagnosed separately. Similarly, if a disease develops as a result of the tooth loss, it should be treated as a new condition- not as a clinical worsening of the original tooth loss.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/loss-teeth-f054-k081k083/rulebase-loss-teeth/fracture-or-disruption-alveolar-bone

Fracture or luxation of the tooth

Current RMA Instruments

Reasonable Hypothesis SOP	29 of 2025
Balance of Probabilities SOP	30 of 2025

Changes from previous Intruments

ICD Coding

ICD-10-AM Codes: K08.1, K08.3, S02.5

Brief Description

Tooth loss means partial or complete permanent loss of a natural adult tooth. Adult teeth, also called permanent or secondary teeth, usually replace baby teeth between the ages of 6 and 12 years old. Wisdom teeth, which are also part of the adult set, usually come in between ages 17 and 21 years old. Sometimes, when a tooth is lost, part of the root of the tooth that sits in the jawbone may still remain. This SOP covers tooth loss with or without retained dental root.

Confirming the diagnosis

Confirmation of tooth loss requires dental or medical records that identifies the affected tooth or teeth.

The tooth or teeth affected should be specified in the diagnostic label used.

Additional diagnoses covered by SOP

Fracture of tooth
Tooth Loss due to surgical extraction

Conditions not covered by SOP

Dental caries* - Tooth decay (dental caries) SOP
Dental pulp disease* - Dental pulp and periapical disease SOP
Periodontitis* - Periodontitis SOP
Tooth wear* - Tooth wear SOP
Superficial tooth wear confined to the enamel - Not a disease

*another SOP applies

#non-SOP condition

Clinical onset

Clinical onset is when the partial or complete loss of a tooth or teeth occurred. In some cases, the date of the injury or disease that led to the tooth loss may differ from the actual date of tooth loss and should not be used as the clinical onset date. Each instance of tooth loss- or loss of a group of teeth resulting from a single cause- should be regarded as a separate clinical onset.

Clinical worsening

The only worsening factor is inability to obtain appropriate clinical management. The loss of an additional tooth or group of teeth should be considered a new condition and diagnosed separately. Similarly, if a disease develops as a result of the tooth loss, it should be treated as a new condition- not as a clinical worsening of the original tooth loss.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/loss-teeth-f054-k081k083/rulebase-loss-teeth/fracture-or-luxation-tooth

Inability to obtain appropriate clinical management for loss of teeth

Current RMA Instruments

Reasonable Hypothesis SOP	29 of 2025
Balance of Probabilities SOP	30 of 2025

Changes from previous Intruments

ICD Coding

ICD-10-AM Codes: K08.1, K08.3, S02.5

Brief Description

Tooth loss means partial or complete permanent loss of a natural adult tooth. Adult teeth, also called permanent or secondary teeth, usually replace baby teeth between the ages of 6 and 12 years old. Wisdom teeth, which are also part of the adult set, usually come in between ages 17 and 21 years old. Sometimes, when a tooth is lost, part of the root of the tooth that sits in the jawbone may still remain. This SOP covers tooth loss with or without retained dental root.

Confirming the diagnosis

Confirmation of tooth loss requires dental or medical records that identifies the affected tooth or teeth.

The tooth or teeth affected should be specified in the diagnostic label used.

Additional diagnoses covered by SOP

Fracture of tooth
Tooth Loss due to surgical extraction

Conditions not covered by SOP

Dental caries* - Tooth decay (dental caries) SOP
Dental pulp disease* - Dental pulp and periapical disease SOP
Periodontitis* - Periodontitis SOP
Tooth wear* - Tooth wear SOP
Superficial tooth wear confined to the enamel - Not a disease

*another SOP applies

#non-SOP condition

Clinical onset

Clinical onset is when the partial or complete loss of a tooth or teeth occurred. In some cases, the date of the injury or disease that led to the tooth loss may differ from the actual date of tooth loss and should not be used as the clinical onset date. Each instance of tooth loss- or loss of a group of teeth resulting from a single cause- should be regarded as a separate clinical onset.

Clinical worsening

The only worsening factor is inability to obtain appropriate clinical management. The loss of an additional tooth or group of teeth should be considered a new condition and diagnosed separately. Similarly, if a disease develops as a result of the tooth loss, it should be treated as a new condition- not as a clinical worsening of the original tooth loss.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/loss-teeth-f054-k081k083/rulebase-loss-teeth/inability-obtain-appropriate-clinical-management-loss-teeth

Periodontitis

Current RMA Instruments

Reasonable Hypothesis SOP	29 of 2025
Balance of Probabilities SOP	30 of 2025

Changes from previous Intruments

ICD Coding

ICD-10-AM Codes: K08.1, K08.3, S02.5

Brief Description

Tooth loss means partial or complete permanent loss of a natural adult tooth. Adult teeth, also called permanent or secondary teeth, usually replace baby teeth between the ages of 6 and 12 years old. Wisdom teeth, which are also part of the adult set, usually come in between ages 17 and 21 years old. Sometimes, when a tooth is lost, part of the root of the tooth that sits in the jawbone may still remain. This SOP covers tooth loss with or without retained dental root.

Confirming the diagnosis

Confirmation of tooth loss requires dental or medical records that identifies the affected tooth or teeth.

The tooth or teeth affected should be specified in the diagnostic label used.

Additional diagnoses covered by SOP

Fracture of tooth
Tooth Loss due to surgical extraction

Conditions not covered by SOP

Dental caries* - Tooth decay (dental caries) SOP
Dental pulp disease* - Dental pulp and periapical disease SOP
Periodontitis* - Periodontitis SOP
Tooth wear* - Tooth wear SOP
Superficial tooth wear confined to the enamel - Not a disease

*another SOP applies

#non-SOP condition

Clinical onset

Clinical onset is when the partial or complete loss of a tooth or teeth occurred. In some cases, the date of the injury or disease that led to the tooth loss may differ from the actual date of tooth loss and should not be used as the clinical onset date. Each instance of tooth loss- or loss of a group of teeth resulting from a single cause- should be regarded as a separate clinical onset.

Clinical worsening

The only worsening factor is inability to obtain appropriate clinical management. The loss of an additional tooth or group of teeth should be considered a new condition and diagnosed separately. Similarly, if a disease develops as a result of the tooth loss, it should be treated as a new condition- not as a clinical worsening of the original tooth loss.

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/h-l/loss-teeth-f054-k081k083/rulebase-loss-teeth/periodontitis

Tooth Loss F054

Current RMA Instruments

29 of 2025

30 of 2025

Changes from previous Intruments

ICD Coding

Brief Description

Confirming the diagnosis

Additional diagnoses covered by SOP

Conditions not covered by SOP

Clinical onset

Clinical worsening

Rulebase for loss of teeth

Avulsion and subsequent replantation of a tooth

Current RMA Instruments

29 of 2025

30 of 2025

Changes from previous Intruments

ICD Coding

Brief Description

Confirming the diagnosis

Additional diagnoses covered by SOP

Conditions not covered by SOP

Clinical onset

Clinical worsening

Dental caries

Current RMA Instruments

29 of 2025

30 of 2025

Changes from previous Intruments

ICD Coding

Brief Description

Confirming the diagnosis

Additional diagnoses covered by SOP

Conditions not covered by SOP

Clinical onset

Clinical worsening

Dental pulp disease

Current RMA Instruments

29 of 2025

30 of 2025

Changes from previous Intruments

ICD Coding

Brief Description

Confirming the diagnosis

Additional diagnoses covered by SOP

Conditions not covered by SOP

Clinical onset

Clinical worsening

Direct physical trauma resulting in avulsion of the tooth

Current RMA Instruments

29 of 2025

30 of 2025

Changes from previous Intruments

ICD Coding

Brief Description

Confirming the diagnosis

Additional diagnoses covered by SOP

Conditions not covered by SOP

Clinical onset

Clinical worsening

Fracture or disruption of the alveolar bone

Current RMA Instruments

29 of 2025

30 of 2025

Changes from previous Intruments

ICD Coding

Brief Description

Confirming the diagnosis

Additional diagnoses covered by SOP

Conditions not covered by SOP

Clinical onset

Clinical worsening

Fracture or luxation of the tooth

Current RMA Instruments

29 of 2025

30 of 2025

Changes from previous Intruments

ICD Coding

Brief Description