K00.5 — Hereditary disturbances in tooth structure, not elsewhere classified
Is K00.5 billable?
Yes, but K00.5 is an unspecified code. K00.5 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, K00.5 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting K00.5 — the more specific alternatives are listed below.
K00.5 at a glance
| Code | K00.5 |
|---|---|
| Description | Hereditary disturbances in tooth structure, not elsewhere classified |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does K00.5 group to?
K00.5 sits in MDC Pre and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 011Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCCsurgical
- 012Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CCsurgical
- 013Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCCsurgical
How is K00.5 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to K00.5. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Amelogenesis imperfecta
- Brown enamel of teeth (hereditary)
- Dentinogenesis imperfecta
- Odontogenesis imperfecta
- Opalescent dentin (hereditary)
- Shell teeth
- Defect, defective › dentin
- Dentin › opalescent
- Dysplasia › dentinal
- Disturbance › tooth › structure, hereditary NEC (s)
Inclusion terms
Alternative wording in documentation that is classified to K00.5.
- Amelogenesis imperfecta
- Dentinogenesis imperfecta
- Odontogenesis imperfecta
- Dentinal dysplasia
- Shell teeth
Excludes2 — not included here — inherited from Chapter 11
The conditions below are not part of K00.5, but a patient may have both at the same time. When documentation supports it, K00.5 and the excluded code may both be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Excludes2 — not included here — inherited from K00
The conditions below are not part of K00.5, but a patient may have both at the same time. When documentation supports it, K00.5 and the excluded code may both be reported.
- embedded and impacted teeth (K01.-)
How long has K00.5 existed?
K00.5 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.