ICD-10 code for dental restoration defect

The ICD-10-CM code for dental restoration defect is K08.50 (Unsatisfactory restoration of tooth, unspecified). The official index lists 1 more specific code, so check the documentation for details such as type, cause, site or severity before settling on K08.50.

Within K08.5, choose K08.50 (unspecified) only when documentation doesn't support a more specific option: open restoration margins of tooth (K08.51), Unrepairable overhanging of dental restorative materials (K08.52), fractured dental restorative material (K08.53), Contour of existing restoration of tooth biologically incompatible with oral health (K08.54), allergy to existing dental restorative material (K08.55), poor aesthetic of existing restoration of tooth (K08.56) and other unsatisfactory restoration of tooth (K08.59).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 011 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCC, relative weight 5.6154), DRG 012 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CC, relative weight 4.381), DRG 013 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCC, relative weight 2.7307), DRG 157 (Dental and Oral Diseases with MCC, relative weight 1.809), DRG 158 (Dental and Oral Diseases with CC, relative weight 0.9366) and DRG 159 (Dental and Oral Diseases without CC/MCC, relative weight 0.6893), in Pre-MDC and MDC 03 (Diseases and Disorders of the Ear, Nose, Mouth and Throat), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.