K03.81 — Cracked tooth
K03.81 is a billable, specific ICD-10-CM code for cracked tooth. 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.
- asymptomatic craze lines in enamel - omit code
- broken or fractured tooth due to trauma (S02.5)
Other codes that can never be billed with K03.81
These codes carry an Excludes1 note pointing at K03.81. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading K03.81 alone.
- S02.5Fracture of tooth (traumatic)
- S02.5XXAFracture of tooth (traumatic), initial encounter for closed fracture
- S02.5XXBFracture of tooth (traumatic), initial encounter for open fracture
- S02.5XXDFracture of tooth (traumatic), subsequent encounter for fracture with routine healing
- S02.5XXGFracture of tooth (traumatic), subsequent encounter for fracture with delayed healing
- S02.5XXKFracture of tooth (traumatic), subsequent encounter for fracture with nonunion
- S02.5XXSFracture of tooth (traumatic), sequela
- K08.53Fractured dental restorative material
Risk adjustment
K03.81 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 K03.81 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 K03.81.
- Cracked tooth
Related codes at this level
Codes that share K03.8. If K03.81 is not quite right, the correct code is usually one of these.
Questions about K03.81
- Is K03.81 a billable ICD-10-CM code?
- Yes. K03.81 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K03.81 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 K03.81?
- K03.81 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.