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ICD-10 Guide
ICD-10 CodesK05.312

K05.312

Billable

Chronic periodontitis, localized, moderate

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

Code Description

ICD-10 K05.312 is a billable code used to indicate a diagnosis of chronic periodontitis, localized, moderate.

Key Diagnostic Point:

Chronic periodontitis, localized, moderate, is characterized by the inflammation of the supporting structures of the teeth, including the gums, periodontal ligament, and alveolar bone. Clinically, it presents with symptoms such as gum swelling, bleeding during brushing, and periodontal pocket formation. This condition primarily affects specific areas of the mouth, leading to the loss of attachment and bone in localized regions. The disease progression can vary, but it typically starts with gingivitis, which, if untreated, can advance to chronic periodontitis. The anatomical structures involved include the gingiva, periodontal ligaments, and the alveolar bone surrounding the teeth. Diagnosis is made through clinical examination, radiographic evaluation, and probing depths to assess attachment loss. Understanding the severity and extent of the disease is crucial for treatment planning and prognosis. Regular dental check-ups and appropriate oral hygiene practices are essential for managing chronic periodontitis effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and radiographic assessment.
  • Treatment complexity: Involves non-surgical and possibly surgical interventions.
  • Documentation requirements: Detailed records of clinical findings and treatment plans are necessary.
  • Coding specificity: Requires precise documentation to differentiate from other periodontal diseases.

Audit Risk Factors

  • Common coding errors: Misclassification of severity or extent of disease.
  • Documentation gaps: Incomplete records of clinical findings or treatment outcomes.
  • Billing challenges: Potential denials due to insufficient documentation or incorrect coding.

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

Chronic periodontitis has significant clinical implications, affecting not only oral health but also systemic health, as it is linked to conditions such as cardiovascular disease and diabetes. The population health impact is substantial, with a high prevalence among adults, leading to increased healthcare utilization for dental and related medical services. Quality measures related to periodontal disease management are crucial for improving patient outcomes and reducing healthcare costs.

ICD-9 vs ICD-10

Chronic periodontitis has significant clinical implications, affecting not only oral health but also systemic health, as it is linked to conditions such as cardiovascular disease and diabetes. The population health impact is substantial, with a high prevalence among adults, leading to increased healthcare utilization for dental and related medical services. Quality measures related to periodontal disease management are crucial for improving patient outcomes and reducing healthcare costs.

Reimbursement & Billing Impact

Reimbursement considerations include the need for detailed records of clinical findings, treatment plans, and follow-up care. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for the procedures performed. Coders should ensure that all services rendered are accurately reflected in the documentation to support the claim and reduce the risk of audits.

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 K05.312?

K05.312 specifically covers moderate localized chronic periodontitis, which includes clinical attachment loss and periodontal pocket formation in specific areas of the mouth. It does not cover generalized periodontitis or other periodontal conditions.

When should K05.312 be used instead of related codes?

K05.312 should be used when there is evidence of moderate chronic periodontitis localized to specific teeth or areas, as opposed to K05.311 for slight or K05.313 for severe cases. Accurate assessment of clinical findings is essential for appropriate code selection.

What documentation supports K05.312?

Documentation should include clinical examination findings, probing depths, radiographic evidence of bone loss, and treatment plans. Detailed notes on patient history and oral hygiene practices are also important to support the diagnosis.