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ICD-10 Guide
ICD-10 CodesK05.219

K05.219

Billable

Aggressive periodontitis, localized, unspecified severity

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

Code Description

ICD-10 K05.219 is a billable code used to indicate a diagnosis of aggressive periodontitis, localized, unspecified severity.

Key Diagnostic Point:

Aggressive periodontitis, localized, unspecified severity, is a severe form of periodontal disease characterized by rapid attachment loss and bone destruction localized to specific teeth. Clinically, it presents with symptoms such as gingival inflammation, pocket formation, and potential tooth mobility. The disease primarily affects adolescents and young adults, although it can occur at any age. The pathophysiology involves a dysregulated immune response to specific bacterial pathogens, leading to localized inflammation and destruction of periodontal tissues. Diagnosis is typically made through clinical examination, radiographic assessment, and periodontal probing. Disease progression can vary, with some patients experiencing rapid deterioration while others may have a more chronic course. Early diagnosis and intervention are crucial to prevent tooth loss and manage the disease effectively. Treatment often includes scaling and root planing, antimicrobial therapy, and, in some cases, surgical intervention to restore periodontal health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough clinical evaluation and understanding of periodontal disease.
  • Treatment complexity: Involves multi-faceted treatment approaches including non-surgical and surgical options.
  • Documentation requirements: Detailed documentation of clinical findings, treatment plans, and patient responses is essential.
  • Coding specificity: Requires accurate coding to differentiate from other forms of periodontitis.

Audit Risk Factors

  • Common coding errors: Misclassification of periodontitis severity or type.
  • Documentation gaps: Incomplete clinical notes or lack of supporting evidence for diagnosis.
  • Billing challenges: Potential denials due to insufficient documentation or incorrect coding.

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, including increased risk of tooth loss and potential systemic health impacts due to the inflammatory nature of the disease. Understanding its prevalence among younger populations is crucial for targeted interventions. Quality measures focusing on periodontal health can improve patient outcomes and reduce healthcare utilization by preventing advanced disease progression.

ICD-9 vs ICD-10

Aggressive periodontitis has significant clinical implications, including increased risk of tooth loss and potential systemic health impacts due to the inflammatory nature of the disease. Understanding its prevalence among younger populations is crucial for targeted interventions. Quality measures focusing on periodontal health can improve patient outcomes and reduce healthcare utilization by preventing advanced disease progression.

Reimbursement & Billing Impact

Reimbursement considerations include the need for detailed notes that justify the diagnosis and treatment plan. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that all relevant procedures are accurately coded and that documentation supports 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 K05.219?

K05.219 covers localized aggressive periodontitis where the severity is unspecified. It is characterized by rapid attachment loss and bone destruction localized to specific teeth, often requiring a comprehensive periodontal evaluation for diagnosis.

When should K05.219 be used instead of related codes?

K05.219 should be used when the clinician identifies localized aggressive periodontitis but cannot specify the severity. It is important to differentiate it from generalized forms or other types of periodontitis that may have different management protocols.

What documentation supports K05.219?

Documentation for K05.219 should include detailed clinical findings such as probing depths, attachment levels, radiographic evidence of bone loss, and treatment plans. Comprehensive notes on patient history and response to previous treatments are also essential.