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K08.54

Billable

Contour of existing restoration of tooth biologically incompatible with oral health

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

The shape or contour of an existing dental restoration does not support healthy oral tissues and may contribute to gum disease or other oral health problems.

Coding Tips

  • Document how the restoration contour is incompatible with oral health (e.g., food traps, gum irritation)
  • Distinguish from aesthetic concerns by focusing on functional and health impacts

Code Hierarchy

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