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ICD-10 Guide
ICD-10 CodesK05.21

K05.21

Non-billable

Aggressive periodontitis, localized

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K05.21 is a used to indicate a diagnosis of aggressive periodontitis, localized.

Key Diagnostic Point:

Aggressive periodontitis, localized, is a severe form of periodontal disease characterized by rapid attachment loss and bone destruction localized to specific teeth, often affecting adolescents and young adults. Clinically, it presents with symptoms such as gingival inflammation, pocket formation, and tooth mobility. The disease primarily involves the periodontal tissues, including the gingiva, periodontal ligament, and alveolar bone. The progression of localized aggressive periodontitis can lead to significant periodontal destruction, often with minimal systemic symptoms. Diagnosis is typically made through clinical examination, radiographic assessment, and microbiological testing to identify specific pathogens associated with the disease. Early intervention is crucial to prevent further periodontal damage and tooth loss, making timely diagnosis and treatment essential for effective management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and potentially microbiological testing.
  • Treatment complexity: May involve surgical and non-surgical interventions, including scaling, root planing, and possibly periodontal surgery.
  • Documentation requirements: Detailed documentation of clinical findings, treatment plans, and patient compliance is necessary.
  • Coding specificity: Requires accurate coding to differentiate from other periodontal diseases.

Audit Risk Factors

  • Common coding errors: Misclassification with other periodontal diseases.
  • Documentation gaps: Incomplete records of clinical findings or treatment plans.
  • Billing challenges: Potential denials if documentation does not support the severity or specificity of the condition.

Specialty Focus

Medical Specialties

Dentistry

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Periodontology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Localized aggressive periodontitis has significant clinical implications, as it can lead to tooth loss and impact overall oral health. Its prevalence in younger populations highlights the need for early detection and intervention. Understanding the epidemiology of this condition can inform public health strategies aimed at improving periodontal health and reducing healthcare utilization associated with advanced periodontal disease.

ICD-9 vs ICD-10

Localized aggressive periodontitis has significant clinical implications, as it can lead to tooth loss and impact overall oral health. Its prevalence in younger populations highlights the need for early detection and intervention. Understanding the epidemiology of this condition can inform public health strategies aimed at improving periodontal health and reducing healthcare utilization associated with advanced periodontal disease.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the treatment and the necessity for detailed records to support the diagnosis. Common denials may arise from insufficient documentation or misclassification of the condition. Best practices include ensuring that all clinical findings are thoroughly documented and that treatment plans align with the diagnosis to avoid billing challenges.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K05.21?

K05.21 specifically covers localized aggressive periodontitis, which is characterized by rapid periodontal tissue destruction localized to specific teeth, often with minimal systemic involvement.

When should K05.21 be used instead of related codes?

K05.21 should be used when the clinical presentation indicates localized aggressive periodontitis, as opposed to generalized forms or other types of periodontal disease, ensuring accurate representation of the patient's condition.

What documentation supports K05.21?

Documentation should include clinical findings such as pocket depths, attachment levels, radiographic evidence of bone loss, and treatment plans. Microbiological testing results may also support the diagnosis.