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K08.531 ICD-10-CM Code: Fractured dental restorative material with loss of material

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
3 Excludes1 · 4 Excludes2

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 011 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC (MDC PRE)
  • MS-DRG 012 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC (MDC PRE)
  • MS-DRG 013 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC (MDC PRE)
  • MS-DRG 157 — DENTAL AND ORAL DISEASES WITH MCC (MDC 03)
  • MS-DRG 158 — DENTAL AND ORAL DISEASES WITH CC (MDC 03)
  • MS-DRG 159 — DENTAL AND ORAL DISEASES WITHOUT CC/MCC (MDC 03)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for K08.531 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on K08.531 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Coder workflow for K08.531

MedCoder structured workflow — derived from this code’s own official record

Before you code K08.531

  1. K08.531’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with K08.531. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in K08.531’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewK03.81, S02.5, Z98.811

Consider K08.531. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).

Official instructions as workflow

  • Excludes1 — check before selecting K08.531(3 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with K08.531: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareK03.81, S02.5, Z98.811

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of K08.531(4 notes)

    Coding workflow: The conditions named in this note are not included in K08.531. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareM27.6, M27.5, M27

    See the official tabular notes · Guidelines I.A.12.b

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition K08.531 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewK03.81, S02.5, Z98.811

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is K08.531 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse K08.531 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of K08.531 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • K03.81— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of cracked tooth moves the case to K03.81; the two are not reported together unless documented as unrelated.

    Full comparison: K08.531 vs K03.81 →

  • S02.5— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of traumatic fracture of tooth moves the case to S02.5; the two are not reported together unless documented as unrelated.

    Full comparison: K08.531 vs S02.5 →

  • Z98.811— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of dental restoration status moves the case to Z98.811; the two are not reported together unless documented as unrelated.

    Full comparison: K08.531 vs Z98.811 →

  • K08.539— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Fractured dental restorative material, unspecified” takes K08.539; specificity in the record moves it back here.

    Full comparison: K08.531 vs K08.539 →

  • M27.6— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of endosseous dental implant failure adds M27.6; it is not part of this code and both may be reported when both are documented.

    Full comparison: K08.531 vs M27.6 →

  • M27.5— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of unsatisfactory endodontic treatment adds M27.5; it is not part of this code and both may be reported when both are documented.

    Full comparison: K08.531 vs M27.5 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Code Overview

Fractured dental restorative material with loss of material is a billable ICD-10-CM diagnosis code (K08.531).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (5)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Official Coding Guidelines

No excerpt in the ICD-10-CM Official Guidelines names this code specifically. Its chapter carries only this chapter-wide note:

Chapter 11: Diseases of the Digestive System (K00-K95)

Reserved for future guideline expansion

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name K08.531 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes2 note: M27.63 — Post-osseointegration mechanical failure of dental implant.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 6 MS-DRGs: DRG 011 (MDC PRE), DRG 012 (MDC PRE), DRG 013 (MDC PRE), DRG 157 (MDC 03), DRG 158 (MDC 03), DRG 159 (MDC 03).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):DIG002 — Disorders of teeth and gingiva (default); DEN001 — Any dental condition including traumatic injury; DEN002 — Nontraumatic dental conditions; DEN003 — Caries, periodontitis, and other preventable dental conditions.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Disorders of teeth and gingiva, Any dental condition including traumatic injury, Nontraumatic dental conditions, Caries, periodontitis, and other preventable dental conditions).

K08.439 — Partial loss of teeth due to caries, unspecified class, K08.491 — Partial loss of teeth due to other specified cause, class I, K08.492 — Partial loss of teeth due to other specified cause, class II, K08.493 — Partial loss of teeth due to other specified cause, class III, K08.494 — Partial loss of teeth due to other specified cause, class IV, K08.499 — Partial loss of teeth due to other specified cause, unspecified class, K08.50 — Unsatisfactory restoration of tooth, unspecified, K08.51 — Open restoration margins of tooth, K08.52 — Unrepairable overhanging of dental restorative materials, K08.530 — Fractured dental restorative material without loss of material, K08.539 — Fractured dental restorative material, unspecified, K08.54 — Contour of existing restoration of tooth biologically incompatible with oral health, K08.55 — Allergy to existing dental restorative material, K08.56 — Poor aesthetic of existing restoration of tooth, K08.59 — Other unsatisfactory restoration of tooth, K08.8 — Other specified disorders of teeth and supporting structures, K08.81 — Primary occlusal trauma, K08.82 — Secondary occlusal trauma, K08.89 — Other specified disorders of teeth and supporting structures, K08.9 — Disorder of teeth and supporting structures, unspecified, +613 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Fracture, pathological”; these codes share that main term but sit in a different category of the Tabular List.

M27.63 — Post-osseointegration mechanical failure of dental implant (dental implant), M48.50 — Collapsed vertebra, not elsewhere classified, site unspecified (compression), M80.00 — Age-related osteoporosis with current pathological fracture, unspecified site (due to, osteoporosis), M84.41 — Pathological fracture, shoulder (scapula), M84.42 — Pathological fracture, humerus (humerus), M84.43 — Pathological fracture, ulna and radius (ulna), M84.44 — Pathological fracture, hand and fingers (finger), M84.45 — Pathological fracture, femur and pelvis (femur), M84.454 — Pathological fracture, pelvis (ilium), M84.459 — Pathological fracture, hip, unspecified (hip), M84.46 — Pathological fracture, tibia and fibula (tibia), M84.47 — Pathological fracture, ankle, foot and toes (toe), M84.48 — Pathological fracture, other site (rib), M84.50 — Pathological fracture in neoplastic disease, unspecified site (due to, neoplastic disease NEC), M84.51 — Pathological fracture in neoplastic disease, shoulder (due to, neoplastic disease NEC, scapula), M84.52 — Pathological fracture in neoplastic disease, humerus (due to, neoplastic disease NEC, humerus), M84.53 — Pathological fracture in neoplastic disease, ulna and radius (due to, neoplastic disease NEC, ulna), M84.54 — Pathological fracture in neoplastic disease, hand (due to, neoplastic disease NEC, finger), M84.55 — Pathological fracture in neoplastic disease, pelvis and femur (due to, neoplastic disease NEC, femur), M84.550 — Pathological fracture in neoplastic disease, pelvis (due to, neoplastic disease NEC, ilium), +21 more

Contextual Map

Every relationship of K08.531 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run K08.531 with this related code in Claim Check

Hierarchy

Referenced by Excludes2 notes

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • Pre-MDC[MDC crossing]: “Pre-MDC — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 175 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
  • MDC 03 — Diseases and Disorders of the Ear, Nose, Mouth and Throat[MDC crossing]: “Diseases and Disorders of the Ear, Nose, Mouth and Throat — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 5,151 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Fracture, pathological (pathologic), dental restorative material, with loss of material[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Fracture, pathological (pathologic), restorative material (dental), with loss of material[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Fracture, traumatic (abduction) (adduction) (separation), dental restorative material, with loss of material[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Fracture, traumatic (abduction) (adduction) (separation), restorative material (dental), with loss of material[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Restorative material (dental), fractured, with loss of material[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "K08.531 — Fractured dental restorative material with loss of material." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/k08.531-fractured-dental-restorative-material-with-loss-of-material

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Fractured dental restorative material with loss of material

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to K08.531 in its code family, with their registry titles.

View all codes in the K08 family