ICD-10 Coding for Periodontitis(K05.311, K05.313)
Complete ICD-10-CM coding and documentation guide for Periodontitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Periodontitis
K05.3-K05.4Primary Range
Chronic and aggressive periodontitis
This range includes the primary codes for chronic and aggressive periodontitis, which are the most common forms of the condition.
Acute periodontitis
This range is relevant for acute presentations of periodontitis, which are less common but clinically significant.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K05.311 | Localized chronic periodontitis, slight | Use for localized periodontitis with slight attachment loss affecting a limited number of teeth. |
|
| K05.313 | Localized chronic periodontitis, severe | Use for severe localized periodontitis with significant attachment loss. |
|
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 periodontitis
Essential facts and insights about Periodontitis
Primary ICD-10-CM Codes for periodontitis
Decision Criteria
clinical Criteria
- Localized attachment loss with slight severity
Applicable To
- Localized slight periodontitis
Excludes
- Acute gingivitis (K05.0)
Clinical Validation Requirements
- 1-2mm clinical attachment loss
- ≤3 teeth affected
Code-Specific Risks
- Misclassification of severity can lead to incorrect coding.
Coding Notes
- Ensure probing depths and attachment loss are documented to support this code.
K05.313 - Localized chronic periodontitis, severe
Use for severe localized periodontitis with significant attachment loss.
Applicable To
- Localized severe periodontitis
Excludes
- Aggressive periodontitis (K05.4)
Clinical Validation Requirements
- ≥5mm clinical attachment loss
- ≥30% sites affected
Coding Notes
Document probing depths and radiographic evidence to support coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Periodontitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K05.311.
Impact
Clinical: Inaccurate assessment of disease severity., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Use standardized periodontal charting forms., Ensure all required measurements are recorded.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Ensure documentation specifies the extent and severity of periodontitis.
Impact
Inaccurate documentation of periodontal findings can lead to audit issues.
Mitigation Strategy
Implement regular training on documentation standards.
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 Periodontitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Periodontitis
Use these documentation templates to ensure complete and accurate documentation for Periodontitis. These templates include all required elements for proper coding and billing.
Chronic periodontitis with moderate severity
Specialty: DentistryRequired Elements
- Probing depths
- Clinical attachment loss
- Radiographic findings
- Bleeding index
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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