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ICD-10 Guide
ICD-10 CodesK05.323

K05.323

Billable

Chronic periodontitis, generalized, severe

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

Code Description

ICD-10 K05.323 is a billable code used to indicate a diagnosis of chronic periodontitis, generalized, severe.

Key Diagnostic Point:

Chronic periodontitis, generalized, severe is a significant oral health condition characterized by the progressive loss of the supporting structures of the teeth, including the periodontal ligament and alveolar bone. Clinically, it presents with symptoms such as gum inflammation, deep periodontal pockets, and tooth mobility. The condition is often associated with systemic diseases and can lead to tooth loss if not adequately managed. The anatomy involved includes the gums (gingiva), periodontal ligaments, and the surrounding alveolar bone. Disease progression typically starts with gingivitis, which, if untreated, advances to chronic periodontitis. Diagnostic considerations include clinical examinations, radiographic assessments to evaluate bone loss, and periodontal probing to measure pocket depths. The severity of the condition is determined by the extent of attachment loss and the depth of periodontal pockets, with generalized severe chronic periodontitis affecting multiple teeth and exhibiting significant clinical attachment loss. Early diagnosis and intervention are crucial to prevent further complications and maintain oral health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough clinical evaluation and radiographic interpretation.
  • Treatment complexity: Involves multi-disciplinary approaches including non-surgical and surgical interventions.
  • Documentation requirements: Detailed records of clinical findings, treatment plans, and patient compliance are essential.
  • Coding specificity: Requires precise coding to differentiate from other periodontal diseases.

Audit Risk Factors

  • Common coding errors: Misclassification of the severity or type of periodontitis.
  • Documentation gaps: Incomplete records of clinical findings or treatment plans.
  • Billing challenges: Potential denials due to lack of supporting documentation for the severity of the condition.

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Chronic periodontitis, particularly in its severe form, has significant clinical implications, affecting not only oral health but also overall systemic health. It is associated with increased healthcare utilization due to complications such as tooth loss and potential links to systemic diseases like diabetes and cardiovascular conditions. Understanding the epidemiology of chronic periodontitis helps in developing targeted prevention strategies and quality measures aimed at improving population health outcomes.

ICD-9 vs ICD-10

Chronic periodontitis, particularly in its severe form, has significant clinical implications, affecting not only oral health but also overall systemic health. It is associated with increased healthcare utilization due to complications such as tooth loss and potential links to systemic diseases like diabetes and cardiovascular conditions. Understanding the epidemiology of chronic periodontitis helps in developing targeted prevention strategies and quality measures aimed at improving population health outcomes.

Reimbursement & Billing Impact

reimbursement considerations include the necessity of detailed clinical notes and treatment plans that justify the services rendered. Denials may occur if documentation does not adequately reflect the severity of the condition or if the treatment provided does not align with the diagnosis. Best practices include regular audits of documentation and coding accuracy to minimize 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 K05.323?

K05.323 covers generalized severe chronic periodontitis, which includes significant attachment loss and periodontal pocket formation affecting multiple teeth. It is characterized by inflammation of the gums and loss of supporting structures, leading to potential tooth loss.

When should K05.323 be used instead of related codes?

K05.323 should be used when the patient presents with generalized severe chronic periodontitis, as indicated by extensive clinical attachment loss and probing depths. It is essential to differentiate it from localized forms or less severe stages of periodontitis.

What documentation supports K05.323?

Documentation for K05.323 should include clinical examination findings, periodontal probing depths, radiographic evidence of bone loss, and treatment plans. Detailed notes on patient history and compliance with treatment recommendations are also necessary.