Is K00.4 a billable ICD-10-CM code?

Yes. K00.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does K00.4 sit in the tabular list?

Diseases of the digestive system (K00-K95), in the block Diseases of oral cavity and salivary glands (K00-K14).

What cannot be coded together with K00.4?

K00.4 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

K00.4

K00.4 — Disturbances in tooth formation

Billable / specific codeICD-10-CM

K00.4 is a billable, specific ICD-10-CM code for disturbances in tooth formation. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

Hutchinson's teeth and mulberry molars in congenital syphilis (A50.5)

Excludes2 — not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

mottled teeth (K00.3)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Aplasia and hypoplasia of cementum
Dilaceration of tooth
Enamel hypoplasia (neonatal) (postnatal) (prenatal)
Regional odontodysplasia
Turner's tooth

Risk adjustment

K00.4 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

How K00.4 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to K00.4.

Dilaceration, tooth
Odontodysplasia, regional
Amelogenesis imperfecta›nonhereditaria(segmentalis)
Aplasia›cementum
Calcification›dentinal papilla
Ghost›teeth
Hypoplasia, hypoplastic›cementum
Hypoplasia, hypoplastic›enamel of teeth(neonatal) (postnatal) (prenatal)
Hypoplasia, hypoplastic›Turner's
Pitting›teeth
Turner's›hypoplasia(tooth)
Turner's›tooth

Related codes at this level

Codes that share K00. If K00.4 is not quite right, the correct code is usually one of these.

Questions about K00.4

Is K00.4 a billable ICD-10-CM code?: Yes. K00.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does K00.4 sit in the tabular list?: Diseases of the digestive system (K00-K95), in the block Diseases of oral cavity and salivary glands (K00-K14).
What cannot be coded together with K00.4?: K00.4 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.