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ICD-10 Coding for Bleeding from Gums(K05.00, K05.10, K06.01)

Complete ICD-10-CM coding and documentation guide for Bleeding from Gums. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Gingival BleedingBleeding Gums

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Related ICD-10 Code Ranges

Complete code families applicable to Bleeding from Gums

K05-K06Primary Range

Diseases of gingiva and periodontal tissues

This range includes codes for gingivitis, periodontitis, and gingival recession, which are relevant to bleeding gums.

Z98.89

History of other specified conditions

Used for patients with a history of periodontal disease affecting current gum bleeding.

R58

Hemorrhage, not elsewhere classified

Applicable for excessive gum bleeding requiring medical intervention.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
K05.00Acute gingivitis, plaque-inducedUse when gingivitis is acute with sudden onset and no attachment loss.
  • Sudden onset of symptoms
  • Erythema and edema
  • Bleeding on gentle probing
K05.10Chronic gingivitis, plaque-inducedUse when gingivitis is chronic with persistent symptoms.
  • Persistent inflammation for over 3 months
  • Bleeding on probing less than 30% of sites
K06.01Localized gingival recessionUse for localized recession with specific root exposure.
  • Root exposure of 1mm or more
  • Localized to specific teeth

Clinical Decision Support

Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.

Key Information: ICD-10 code for bleeding from gums

Essential facts and insights about Bleeding from Gums

The ICD-10 code for acute gingivitis, which can cause bleeding from gums, is K05.00. Chronic gingivitis is coded as K05.10.

Primary ICD-10-CM Codes for bleeding from gums

K05.00
Acute gingivitis, plaque-induced
Billable Code

Decision Criteria

clinical Criteria

  • Sudden onset of gingival inflammation with bleeding

Applicable To

  • Sudden onset gingival inflammation
  • Bleeding on probing

Excludes

Clinical Validation Requirements

  • Sudden onset of symptoms
  • Erythema and edema
  • Bleeding on gentle probing

Code-Specific Risks

  • Misclassification as chronic gingivitis

Coding Notes

  • Ensure documentation specifies acute nature and absence of attachment loss.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

History of periodontal disease

Z98.89
Use for patients with a history of periodontitis affecting current condition.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Chronic gingivitis, plaque-induced

K05.10
Chronic gingivitis persists for more than 3 months with less than 30% bleeding on probing.

Acute gingivitis, plaque-induced

K05.00
Acute gingivitis has a sudden onset with more than 30% bleeding on probing.

Generalized gingival recession

K06.02
Generalized recession affects multiple teeth across the arch.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Bleeding from Gums to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K05.00.

Impact

Clinical: Inadequate treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient documentation.

Mitigation Strategy

Use specific clinical terms and measurements., Include detailed periodontal charting.

Impact

Reimbursement: Incorrect billing can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation Strategy

Use D4346 for therapeutic scaling when inflammation exceeds prophylaxis criteria.

Impact

Misclassification of acute vs. chronic gingivitis can lead to audit issues.

Mitigation Strategy

Ensure documentation clearly differentiates between acute and chronic conditions.

Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.

Frequently Asked Questions

Common questions about ICD-10 coding for Bleeding from Gums, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Bleeding from Gums

Use these documentation templates to ensure complete and accurate documentation for Bleeding from Gums. These templates include all required elements for proper coding and billing.

Generalized moderate gingivitis with bleeding

Specialty: General Dentistry

Required Elements

  • Assessment of gingival condition
  • Probing depths and bleeding sites
  • Treatment plan and patient education

Example Documentation

Assessment: Generalized moderate gingivitis with 50% BOP. Treatment: D4346 scaling performed. OHI provided.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Bleeding gums noted.
Good Documentation Example
Generalized moderate BOP (60% sites) with 4mm pseudo-pockets, no attachment loss on full-mouth probing ≤3mm.
Explanation
The good example provides specific clinical findings and measurements, enhancing documentation quality.

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