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ICD-10 Guide
ICD-10 CodesK05.223

K05.223

Billable

Aggressive periodontitis, generalized, severe

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

Code Description

ICD-10 K05.223 is a billable code used to indicate a diagnosis of aggressive periodontitis, generalized, severe.

Key Diagnostic Point:

Aggressive periodontitis, generalized, severe, is a severe form of periodontal disease characterized by rapid attachment loss and bone destruction. It typically affects adolescents and young adults, although it can occur at any age. Clinically, patients may present with symptoms such as swollen, bleeding gums, and increased tooth mobility. The disease is often associated with specific microbial profiles, including high levels of Aggregatibacter actinomycetemcomitans and other periodontal pathogens. The anatomy involved includes the periodontal tissues, which consist of the gums, periodontal ligament, and alveolar bone. Disease progression can lead to significant tooth loss if not managed promptly. Diagnostic considerations include clinical examination, radiographic evaluation, and microbiological testing to identify pathogenic bacteria. Early intervention is crucial to prevent further periodontal destruction and maintain oral health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough clinical and microbiological evaluation.
  • Treatment complexity: Involves multi-disciplinary approaches including periodontal therapy and possibly surgical interventions.
  • Documentation requirements: Detailed documentation of clinical findings, treatment plans, and patient compliance is necessary.
  • Coding specificity: Requires precise coding to differentiate from other forms of periodontitis.

Audit Risk Factors

  • Common coding errors: Misclassification with other periodontal diseases.
  • Documentation gaps: Incomplete records of clinical findings and treatment plans.
  • Billing challenges: Potential denials due to lack of supporting documentation.

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: Periodontics

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Aggressive periodontitis has significant clinical implications, as it can lead to early tooth loss and impact overall health. The condition is prevalent among younger populations, affecting their quality of life and increasing healthcare utilization. Understanding its epidemiology is crucial for developing preventive strategies and improving oral health outcomes in affected populations. Quality measures should focus on early detection and effective management to reduce the burden of this disease.

ICD-9 vs ICD-10

Aggressive periodontitis has significant clinical implications, as it can lead to early tooth loss and impact overall health. The condition is prevalent among younger populations, affecting their quality of life and increasing healthcare utilization. Understanding its epidemiology is crucial for developing preventive strategies and improving oral health outcomes in affected populations. Quality measures should focus on early detection and effective management to reduce the burden of this disease.

Reimbursement & Billing Impact

Reimbursement considerations include verifying the patient's insurance coverage for periodontal treatments, as some plans may have limitations. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include maintaining thorough records of clinical assessments, treatment plans, and patient responses to therapy to support claims effectively.

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 K05.223?

K05.223 specifically covers generalized aggressive periodontitis, which is characterized by rapid attachment loss and bone destruction affecting multiple teeth. It is distinguished from other forms of periodontitis by its severity and the age of onset.

When should K05.223 be used instead of related codes?

K05.223 should be used when the patient presents with generalized aggressive periodontitis that is severe in nature, as opposed to localized forms or less severe cases. Accurate diagnosis and clinical findings are essential for appropriate code selection.

What documentation supports K05.223?

Documentation should include a comprehensive periodontal examination, radiographic evidence of bone loss, clinical findings such as probing depths and attachment levels, and any microbiological testing results that support the diagnosis of aggressive periodontitis.