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ICD-10 Guide
ICD-10 CodesK05.31

K05.31

Non-billable

Chronic periodontitis, localized

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

Code Description

ICD-10 K05.31 is a used to indicate a diagnosis of chronic periodontitis, localized.

Key Diagnostic Point:

Chronic periodontitis, localized, is a common inflammatory disease affecting the supporting structures of the teeth, primarily the gums and bone. Clinically, it presents with symptoms such as gum inflammation, pocket formation, and potential tooth mobility. The disease is characterized by the progressive loss of periodontal attachment and bone, often localized to specific teeth or areas of the mouth. The anatomy involved includes the gingiva, periodontal ligament, and alveolar bone. Disease progression can vary, with localized chronic periodontitis typically affecting one or a few teeth, leading to significant periodontal tissue destruction if left untreated. Diagnostic considerations include clinical examination, probing depths, and radiographic assessment to evaluate bone loss. The disease is often associated with risk factors such as poor oral hygiene, smoking, diabetes, and genetic predisposition, necessitating a comprehensive approach to diagnosis and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and radiographic analysis.
  • Treatment complexity: Involves non-surgical and surgical interventions, patient compliance, and follow-up.
  • Documentation requirements: Detailed records of clinical findings, treatment plans, and patient education.
  • Coding specificity: Requires precise coding to differentiate between localized and generalized forms.

Audit Risk Factors

  • Common coding errors: Misclassification of localized vs. generalized periodontitis.
  • Documentation gaps: Incomplete records of clinical findings and treatment plans.
  • 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

Chronic periodontitis, localized, has significant clinical implications, affecting not only oral health but also overall systemic health. It is linked to various systemic conditions such as cardiovascular disease and diabetes. Population health impact is notable, as periodontal disease is prevalent in many demographics, influencing healthcare utilization patterns. Quality measures often include the assessment of periodontal health in routine dental care, emphasizing the importance of early diagnosis and intervention to improve patient outcomes.

ICD-9 vs ICD-10

Chronic periodontitis, localized, has significant clinical implications, affecting not only oral health but also overall systemic health. It is linked to various systemic conditions such as cardiovascular disease and diabetes. Population health impact is notable, as periodontal disease is prevalent in many demographics, influencing healthcare utilization patterns. Quality measures often include the assessment of periodontal health in routine dental care, emphasizing the importance of early diagnosis and intervention to improve patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the need for pre-authorization for certain procedures and ensuring that all services rendered are supported by clinical documentation. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include maintaining thorough records of patient assessments, treatment plans, and follow-up care to support claims and reduce audit risks.

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 K05.31?

K05.31 specifically covers chronic periodontitis that is localized to certain teeth or areas, characterized by attachment loss and pocket formation. It does not include generalized periodontitis or other periodontal diseases.

When should K05.31 be used instead of related codes?

K05.31 should be used when the clinical evaluation indicates localized chronic periodontitis, with specific documentation of affected areas. It should not be used for generalized forms or other periodontal conditions.

What documentation supports K05.31?

Documentation should include clinical findings such as probing depths, attachment levels, radiographic evidence of bone loss, and treatment plans. Detailed notes on patient history and risk factors are also essential.