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ICD-10 Guide
ICD-10 CodesK05.211

K05.211

Billable

Aggressive periodontitis, localized, slight

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

Code Description

ICD-10 K05.211 is a billable code used to indicate a diagnosis of aggressive periodontitis, localized, slight.

Key Diagnostic Point:

Aggressive periodontitis, localized, slight, is a form of periodontal disease characterized by rapid attachment loss and bone destruction localized to specific teeth, often affecting adolescents and young adults. Clinically, it presents with minimal plaque accumulation relative to the severity of periodontal tissue destruction, which can lead to tooth mobility and potential loss. The disease primarily involves the periodontal tissues, including the gingiva, periodontal ligament, and alveolar bone. The progression of localized aggressive periodontitis can be rapid, often leading to significant periodontal destruction within a short time frame. Diagnostic considerations include clinical examination, radiographic assessment, and microbiological testing to identify specific pathogens associated with the disease. Early diagnosis and intervention are crucial to prevent further periodontal damage and tooth loss, making it essential for healthcare providers to recognize the signs and symptoms associated with this condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough clinical evaluation and may involve advanced diagnostic tools.
  • Treatment complexity: Treatment may involve non-surgical and surgical interventions, including scaling, root planing, and possibly periodontal surgery.
  • 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 of the severity of periodontitis.
  • Documentation gaps: Incomplete clinical notes or lack of supporting evidence for diagnosis.
  • Billing challenges: Potential for denials if documentation does not support the level of care provided.

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, localized, slight, has significant clinical implications as it can lead to early tooth loss and impact overall oral health. Its prevalence in younger populations highlights the need for early detection and intervention. Understanding the epidemiology of this condition can inform public health strategies aimed at improving oral health outcomes and reducing healthcare utilization related to periodontal diseases.

ICD-9 vs ICD-10

Aggressive periodontitis, localized, slight, has significant clinical implications as it can lead to early tooth loss and impact overall oral health. Its prevalence in younger populations highlights the need for early detection and intervention. Understanding the epidemiology of this condition can inform public health strategies aimed at improving oral health outcomes and reducing healthcare utilization related to periodontal diseases.

Reimbursement & Billing Impact

Reimbursement considerations include verifying the patient's insurance coverage for periodontal treatments, as some plans may have specific requirements for prior authorization. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include maintaining thorough clinical notes, ensuring accurate coding, and regularly reviewing payer guidelines 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 K05.211?

K05.211 specifically covers localized aggressive periodontitis with slight attachment loss and bone destruction. It is characterized by rapid progression and is often seen in younger patients with minimal plaque buildup.

When should K05.211 be used instead of related codes?

K05.211 should be used when the clinical presentation indicates localized aggressive periodontitis with slight severity. It is important to differentiate it from moderate or generalized forms of periodontitis based on clinical findings and radiographic evidence.

What documentation supports K05.211?

Documentation should include a comprehensive periodontal examination, clinical attachment level measurements, radiographic evidence of bone loss, and any microbiological testing results that support the diagnosis of localized aggressive periodontitis.