ICD-10-CM · Other

M26.24

M26.24 classifies reverse articulation — a dental arch relationship anomaly in which the normal occlusal relationship is reversed, including anterior and posterior crossbite.

Verified May 8, 2026 · 5 sources ↓

Status
Billable
Chapter
13
Related CPT
10
Region
Other
Drawn from CDCICD10DataAAPCIcd10codedCMS

Documentation tips

What should appear in the chart to support M26.24.

Source · Editorial brief grounded in 5 cited references ↓

  • Specify whether the crossbite is anterior, posterior, or both — though all map to M26.24, documentation supports medical necessity for orthodontic or surgical planning.
  • Record which teeth or dental segments are affected (e.g., teeth #6–#11 for anterior crossbite) to substantiate the clinical picture for preauthorization and audit purposes.
  • Document the functional impact where present — speech difficulty, chewing dysfunction, or temporomandibular joint stress — to support medical necessity over cosmetic classification.
  • If an Angle's class malocclusion coexists, document the class (I, II, or III) separately so M26.211–M26.219 can be coded alongside M26.24 when both are clinically present.
  • Note any prior orthodontic or orthopedic treatment attempts when coding for surgical correction, as payers frequently require evidence of failed conservative management.

Related CPT procedures

Procedure codes commonly billed with M26.24. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

21198 $908.84
Surgical reconstruction of a lower jaw (mandibular) segment, typically involving osteotomy and repositioning or rebuilding of bone to correct deformity from trauma, disease, or congenital origin.
21199 $906.17
Segmental mandibular osteotomy with genioglossus muscle advancement — the lower jaw is cut in segments, repositioned, and the tongue-base muscle attachment is advanced forward.
21206 $873.43
Surgical reconstruction of the maxilla (upper jaw) via osteotomy — cutting and repositioning the bone to correct deformity from trauma, congenital defect, or disease.
21244 $897.48
Extraoral mandibular reconstruction using a transosteal bone plate — such as a mandibular staple bone plate — to restore structural integrity and function of the lower jaw.
21245 $1,286.27
Partial reconstruction of the mandible or maxilla using a subperiosteal implant — a custom metal framework placed on top of the jawbone beneath the periosteum to restore structural integrity and function.
21246 $767.89
Complete subperiosteal implant reconstruction of the mandible or maxilla, placing a custom implant on top of the jawbone beneath the periosteum to restore jaw structure and function.
21247 $1,419.20
Reconstruction of the mandibular condyle using bone and cartilage harvested from the patient's own body, including autograft harvest, typically performed for congenital jaw deformity such as hemifacial microsomia.
21240 $943.58
Arthroplasty of the temporomandibular joint using autogenous graft material harvested from the patient, performed to restore jaw function.
21242 $923.20
Arthroplasty of the temporomandibular joint using allograft (donor) tissue to repair, reposition, or reconstruct joint components.
21243 $1,456.28
Arthroplasty of the temporomandibular joint using a prosthetic joint replacement device

Common coding pitfalls

The recurring mistakes coders make with M26.24 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

  • Assigning M26.20 (unspecified anomaly of dental arch relationship) when the record clearly documents crossbite — M26.24 is the specific billable code and should be used whenever crossbite is documented.
  • Confusing anterior crossbite with Angle's class III malocclusion (M26.213): anterior crossbite is a tooth-level positional finding; Angle's class III is a skeletal-dental relationship classification. Both may coexist and may both be coded.
  • Omitting M26.24 when the primary claim is a jaw osteotomy — crossbite or reverse articulation is frequently the documented indication driving surgical intervention and must appear on the claim.
  • Applying a 7th-character extension to M26.24 — M-codes in this section do not use 7th-character extensions; adding one creates an invalid code.

Clinical context

Source · Editorial summary grounded in 5 cited references ↓

M26.24 captures reverse articulation of the teeth, with the ICD-10-CM tabular explicitly including crossbite (anterior) and crossbite (posterior) as covered conditions under this single code. The term 'reverse articulation' refers to an abnormal occlusal relationship where one or more mandibular teeth occlude labially or buccally to the opposing maxillary teeth — the inverse of the standard overjet relationship. Both anterior crossbite (front teeth) and posterior crossbite (back teeth) map to this same code; there is no separate laterality or segment-specific subdivision within M26.24.

This code sits within the M26.2 parent block (anomalies of dental arch relationship) under the broader dentofacial anomalies section M26–M27. It is primarily used in oral and maxillofacial surgery, orthodontic, and dental practice settings, but may appear on orthopedic or craniofacial surgery claims when jaw realignment procedures are performed. Coders supporting oral-maxillofacial surgical cases should confirm whether a concurrent Angle's class malocclusion (M26.211–M26.219) or other arch relationship anomaly warrants an additional code from the M26.2 block.

For MS-DRG grouping, M26.24 maps to DRGs 011–013 (tracheostomy for face, mouth, and neck diagnoses) and DRGs 157–159 (dental and oral diseases), with CC/MCC splits driving the specific DRG assignment. No 7th-character extension applies to this M-code.

Inclusion & exclusion notes

Per the official ICD-10-CM Tabular List.

Source · CDC ICD-10-CM Official Tabular List · 2026

Includes

  • Crossbite (anterior) (posterior)

Sibling codes

Other billable codes under M26.2 (laterality / anatomic variants).

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01Does M26.24 cover both anterior and posterior crossbite?
Yes. The ICD-10-CM tabular lists 'Crossbite (anterior) (posterior)' as an inclusion term under M26.24. Both types map to this single code; there is no separate code by crossbite location.
02Can M26.24 and M26.213 (Angle's class III) be coded together?
Yes, when both are documented and clinically distinct. Anterior crossbite is a tooth-position finding; Angle's class III is a broader jaw relationship classification. If the provider documents both, assign both codes.
03Is M26.24 appropriate for an orthopedic coder, or is it dental-only?
It can appear on oral-maxillofacial surgery claims billed in orthopedic or surgical practice settings, particularly when jaw osteotomy or craniofacial procedures are performed to correct crossbite. Context determines applicability.
04What MS-DRGs does M26.24 group to?
M26.24 groups to MS-DRG 011–013 (tracheostomy for face, mouth, and neck diagnoses with/without CC/MCC) and MS-DRG 157–159 (dental and oral diseases with/without CC/MCC) per MS-DRG v43.0.
05Should I use M26.20 if the documentation just says 'crossbite' without specifying anterior or posterior?
No. 'Crossbite' without further specification still maps to M26.24 per the ICD-10-CM diagnosis index. M26.20 is for arch relationship anomalies that are genuinely unspecified, not for crossbite.
06Does M26.24 require a 7th character?
No. M-codes in the dentofacial anomalies section do not carry 7th-character extensions. Appending any character beyond the fifth produces an invalid code.
07How does reverse articulation differ from excessive horizontal overlap (M26.23)?
Excessive horizontal overlap (M26.23) codes increased overjet — where upper teeth protrude further than normal over the lower. Reverse articulation (M26.24) is the opposite: lower teeth sit labial or buccal to the upper, i.e., a crossbite or negative overjet. They are mutually exclusive findings.

Mira AI Scribe

Mira AI Scribe captures the type of crossbite (anterior, posterior, or both), the specific teeth or segments involved, any functional complaints (chewing difficulty, speech impact, TMJ symptoms), and prior treatment history. This documentation prevents downcoding to the unspecified M26.20, satisfies payer medical necessity requirements distinguishing functional from cosmetic indications, and supports concurrent coding of a coexisting Angle's class malocclusion when present.

See how Mira captures M26.24 documentation

Related ICD-10 codes

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