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ICD-10 Guide
ICD-10 CodesK05.213

K05.213

Billable

Aggressive periodontitis, localized, severe

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

Code Description

ICD-10 K05.213 is a billable code used to indicate a diagnosis of aggressive periodontitis, localized, severe.

Key Diagnostic Point:

Aggressive periodontitis, localized, severe, is a specific 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 deep periodontal pockets, significant inflammation, and often the presence of specific bacteria such as Aggregatibacter actinomycetemcomitans. The disease primarily affects the periodontal tissues, including the gums, periodontal ligament, and alveolar bone. Progression can lead to tooth mobility and loss if untreated. Diagnosis is based on clinical examination, radiographic findings, and microbiological testing. The disease may be associated with systemic conditions, making comprehensive evaluation essential. Treatment typically involves scaling and root planing, possible surgical interventions, and ongoing maintenance therapy. Regular follow-ups are crucial to monitor disease progression and response to treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough clinical evaluation and possibly microbiological testing.
  • Treatment complexity: Involves multi-disciplinary approaches including dental specialists.
  • 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 or treatment plans.
  • Billing challenges: Potential denials due to lack of supporting documentation.

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

Aggressive periodontitis has significant clinical implications, affecting not only oral health but also potentially contributing to systemic conditions such as cardiovascular disease. Understanding its epidemiology is crucial for population health, as early diagnosis and treatment can reduce healthcare utilization and improve quality of life. Monitoring quality measures related to periodontal health can help in assessing the effectiveness of interventions.

ICD-9 vs ICD-10

Aggressive periodontitis has significant clinical implications, affecting not only oral health but also potentially contributing to systemic conditions such as cardiovascular disease. Understanding its epidemiology is crucial for population health, as early diagnosis and treatment can reduce healthcare utilization and improve quality of life. Monitoring quality measures related to periodontal health can help in assessing the effectiveness of interventions.

Reimbursement & Billing Impact

Reimbursement considerations include the need for pre-authorization for surgical interventions and ensuring that all claims are supported by detailed clinical notes. Common denials may arise from insufficient documentation or misclassification of the condition. Best practices include thorough record-keeping and regular audits to ensure compliance with coding guidelines.

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 K05.213?

K05.213 specifically covers localized aggressive periodontitis, which is characterized by rapid attachment loss and bone destruction localized to specific teeth, primarily affecting younger populations.

When should K05.213 be used instead of related codes?

K05.213 should be used when the clinical presentation indicates localized aggressive periodontitis with severe attachment loss, differentiating it from chronic periodontitis or generalized aggressive forms.

What documentation supports K05.213?

Documentation should include clinical examination findings, radiographic evidence of bone loss, treatment plans, and follow-up evaluations to support the diagnosis of localized aggressive periodontitis.