Dental and Oral Conditions

(Organized Alphabetically by Condition Name)
Hard Palate Missing, Partial or Complete (Codes 9911โ9912)
Adjustment Disorder
- Code 9440: Chronic adjustment disorder
Hard Palate Missing, Partial or Complete (Codes 9911โ9912)
-
Code 9911:
- 30%: Half or more of the hard palate is missing and cannot be replaced with a prosthesis.
- 10%: Half or more of the hard palate is missing but can be replaced with a prosthesis.
-
Code 9912:
- 20%: Less than half of the hard palate is missing and cannot be replaced with a prosthesis.
- 0%: Less than half of the hard palate is missing but can be replaced with a prosthesis.
-
Code 9911:
Mandible Missing or Defective (Codes 9902โ9904)
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Code 9902:
- 50%: About half of the mandible is missing, and jaw motion is severely limited or immobile.
- 30%: About half of the mandible is missing, but jaw motion is unaffected.
-
Code 9903:
- 30%: Mandible broken and failed to heal properly, causing severe limitation.
- 10%: Mandible broken and failed to heal properly, causing moderate limitation.
-
Code 9904:
- 20%: Mandible healed incorrectly, causing severe disfigurement.
- 10%: Mandible healed incorrectly, causing moderate disfigurement.
- 0%: Mandible healed incorrectly but with slight disfigurement.
Maxilla Defects (Code 9916)
-
Code 9916:
- 30%: Maxilla broken and severely disfigured.
- 10%: Maxilla broken and moderately disfigured.
- 0%: Maxilla broken and slightly disfigured.
Osteomyelitis or Osteoradionecrosis of the Mandible (Code 9900)
- Description: Rated underย 5000ย for osteomyelitis.
Dissociative and Depersonalization Disorders
You will receive your first payment within 1-2 months after discharge.
Ramus Missing, Partial or Complete (Codes 9906โ9907)
-
Code 9906:
- 50%: More than half of the ramus is missing on both sides, with impaired chewing or jaw movement.
- 30%: More than half of the ramus is missing on one side, with impaired chewing or jaw movement.
- 30%: More than half of the ramus is missing on both sides, but jaw function is unaffected.
- 20%: More than half of the ramus is missing on one side, but jaw function is unaffected.
-
Code 9907:
- 10%: Less than half of the ramus is missing on one side, with no impact on jaw function.
- 20%: Less than half of the ramus is missing on both sides, with no impact on jaw function.
Temporomandibular Joint (TMJ) Dysfunction and Other Jaw Joint Conditions (Code 9905)
-
Code 9905:
- 40%: Jaw cannot open more than 10 mm (0.4 inches).
- 30%: Jaw opens between 11โ20 mm (0.4โ0.8 inches).
- 20%: Jaw opens between 21โ30 mm (0.8โ1.2 inches).
- 10%: Jaw opens between 31โ40 mm (1.2โ1.6 inches) or cannot move side-to-side more than 4 mm.
Severity Matters
Ratings are determined by the extent of bone loss, jaw immobility, and functional impairment.
Prosthesis Use
The availability and effectiveness of prosthetics for palate issues directly impact the rating percentage.
Choose Higher Ratings
For conditions with overlapping symptoms, only the more limiting motion or defect is rated.
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