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ICD-10 Guide
ICD-10 CodesK05.319

K05.319

Billable

Chronic periodontitis, localized, unspecified severity

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

Code Description

ICD-10 K05.319 is a billable code used to indicate a diagnosis of chronic periodontitis, localized, unspecified severity.

Key Diagnostic Point:

Chronic periodontitis is a common inflammatory condition affecting the supporting structures of the teeth, characterized by the progressive loss of periodontal attachment and bone. The localized form of chronic periodontitis, as denoted by K05.319, indicates that the disease is confined to specific areas of the mouth rather than being generalized. Clinically, patients may present with symptoms such as gum inflammation, pocket formation, and potential tooth mobility. The anatomy involved includes the gums (gingiva), periodontal ligaments, and alveolar bone. Disease progression can lead to significant oral health issues, including tooth loss if not managed appropriately. Diagnostic considerations for K05.319 include clinical examination, radiographic evaluation to assess bone loss, and probing depths to determine the extent of periodontal involvement. The severity is unspecified, which may necessitate further evaluation to determine the appropriate treatment plan.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and radiographic assessment.
  • Treatment complexity: May involve non-surgical and surgical interventions depending on disease severity.
  • Documentation requirements: Detailed documentation of clinical findings and treatment plans is essential.
  • Coding specificity: Requires accurate coding to differentiate from other periodontal diseases.

Audit Risk Factors

  • Common coding errors: Misclassification of severity or type of periodontitis.
  • Documentation gaps: Incomplete records of clinical findings or treatment plans.
  • Billing challenges: Potential denials if documentation does not support the diagnosis.

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, particularly in its localized form, has significant clinical implications, affecting not only oral health but also systemic health due to its association with conditions such as cardiovascular disease and diabetes. Population health impact is notable, as periodontal disease is prevalent and can lead to increased healthcare utilization, including dental visits and potential surgical interventions. Quality measures in dentistry increasingly focus on the management of periodontal diseases, highlighting the importance of early diagnosis and effective treatment strategies.

ICD-9 vs ICD-10

Chronic periodontitis, particularly in its localized form, has significant clinical implications, affecting not only oral health but also systemic health due to its association with conditions such as cardiovascular disease and diabetes. Population health impact is notable, as periodontal disease is prevalent and can lead to increased healthcare utilization, including dental visits and potential surgical interventions. Quality measures in dentistry increasingly focus on the management of periodontal diseases, highlighting the importance of early diagnosis and effective treatment strategies.

Reimbursement & Billing Impact

Reimbursement considerations include the need for detailed clinical notes that justify the diagnosis and treatment provided. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that all services rendered are clearly linked to the diagnosis and that any procedures performed are appropriately coded to avoid billing issues.

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 K05.319?

K05.319 covers localized chronic periodontitis, which may present with symptoms such as gum swelling, pocket formation, and localized bone loss. It is important to differentiate it from other periodontal diseases and conditions.

When should K05.319 be used instead of related codes?

K05.319 should be used when the chronic periodontitis is localized and the severity is unspecified. If the severity is known, other codes may be more appropriate, such as K05.311 for localized chronic periodontitis with mild severity.

What documentation supports K05.319?

Documentation should include clinical findings from periodontal examinations, radiographic evidence of bone loss, probing depths, and a treatment plan that outlines the management of the localized condition.