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ICD-10 Guide
ICD-10 CodesK05.212

K05.212

Billable

Aggressive periodontitis, localized, moderate

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

Code Description

ICD-10 K05.212 is a billable code used to indicate a diagnosis of aggressive periodontitis, localized, moderate.

Key Diagnostic Point:

Aggressive periodontitis, localized, moderate, is a severe form of periodontal disease characterized by rapid attachment loss and bone destruction localized to specific teeth, typically affecting adolescents and young adults. Clinically, it presents with deep periodontal pockets, gingival inflammation, and potential tooth mobility. The disease primarily involves the supporting structures of the teeth, including the alveolar bone and periodontal ligament. The progression of localized aggressive periodontitis can vary, but it often leads to significant periodontal destruction if not managed effectively. Diagnostic considerations include clinical examination, radiographic assessment to evaluate bone loss, and microbiological testing to identify specific pathogens associated with the disease. Early diagnosis and intervention are crucial to prevent further periodontal damage and tooth loss, emphasizing the importance of comprehensive dental evaluations in at-risk populations.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough clinical and radiographic evaluation.
  • Treatment complexity: May involve surgical and non-surgical interventions.
  • Documentation requirements: Detailed records of clinical findings and treatment plans are necessary.
  • Coding specificity: Requires precise 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.
  • Billing challenges: Potential denials due to insufficient documentation or coding errors.

Specialty Focus

Medical Specialties

Primary medical specialty: 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

Secondary specialty: 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

Aggressive periodontitis, particularly localized forms, has significant clinical implications, affecting not only oral health but also overall systemic health. The condition can lead to tooth loss and has been associated with other systemic diseases, impacting population health. Quality measures in dental care increasingly focus on early detection and management of periodontal diseases, influencing healthcare utilization patterns. Epidemiologically, localized aggressive periodontitis is more prevalent in younger populations, necessitating targeted public health strategies to improve oral health outcomes.

ICD-9 vs ICD-10

Aggressive periodontitis, particularly localized forms, has significant clinical implications, affecting not only oral health but also overall systemic health. The condition can lead to tooth loss and has been associated with other systemic diseases, impacting population health. Quality measures in dental care increasingly focus on early detection and management of periodontal diseases, influencing healthcare utilization patterns. Epidemiologically, localized aggressive periodontitis is more prevalent in younger populations, necessitating targeted public health strategies to improve oral health outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include verifying the patient's insurance coverage for periodontal treatments. Common denials may arise from insufficient documentation or failure to provide evidence of medical necessity. Coders should ensure that all relevant clinical findings, treatment plans, and progress notes are included to support the claim. Best practices include regular audits of documentation and coding accuracy to minimize 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 K05.212?

K05.212 specifically covers localized aggressive periodontitis, which is characterized by rapid attachment loss and bone destruction localized to specific teeth, typically affecting younger individuals.

When should K05.212 be used instead of related codes?

K05.212 should be used when the patient presents with localized aggressive periodontitis, as opposed to generalized forms or other types of periodontal diseases, ensuring accurate representation of the condition.

What documentation supports K05.212?

Documentation should include clinical findings such as probing depths, attachment levels, radiographic evidence of bone loss, and treatment plans, along with any microbiological testing results.