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ICD-10 Guide
ICD-10 CodesK05.30

K05.30

Billable

Chronic periodontitis, unspecified

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

Code Description

ICD-10 K05.30 is a billable code used to indicate a diagnosis of chronic periodontitis, unspecified.

Key Diagnostic Point:

Chronic periodontitis is a common inflammatory disease affecting the supporting structures of the teeth, primarily the gums and bone. It is characterized by the gradual loss of attachment of the periodontal ligament and alveolar bone, leading to pocket formation and potential tooth mobility. Clinically, patients may present with symptoms such as gum inflammation, bleeding during brushing, and halitosis. The disease typically progresses slowly, often unnoticed until significant damage has occurred. The anatomy involved includes the gingiva, periodontal ligament, cementum, and alveolar bone. Diagnostic considerations for chronic periodontitis include clinical examination, probing depth measurements, and radiographic assessment to evaluate bone loss. The condition can be exacerbated by factors such as poor oral hygiene, smoking, diabetes, and genetic predisposition, making it essential for healthcare providers to assess these risk factors during diagnosis and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and radiographic interpretation.
  • Treatment complexity: May involve non-surgical and surgical interventions, including scaling and root planing.
  • Documentation requirements: Detailed records of clinical findings, treatment plans, and patient compliance are necessary.
  • Coding specificity: Requires differentiation from other periodontal diseases, necessitating precise documentation.

Audit Risk Factors

  • Common coding errors: Misclassification with other periodontal diseases.
  • Documentation gaps: Incomplete records of clinical findings or treatment plans.
  • Billing challenges: Potential denials due to lack of specificity or insufficient documentation.

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: 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 has significant clinical implications, affecting not only oral health but also overall health, as it is linked to systemic conditions such as cardiovascular disease and diabetes. The prevalence of chronic periodontitis in the population underscores the need for effective preventive measures and treatment strategies. Quality measures in dental care increasingly focus on the management of periodontal diseases, influencing healthcare utilization patterns and emphasizing the importance of early diagnosis and intervention.

ICD-9 vs ICD-10

Chronic periodontitis has significant clinical implications, affecting not only oral health but also overall health, as it is linked to systemic conditions such as cardiovascular disease and diabetes. The prevalence of chronic periodontitis in the population underscores the need for effective preventive measures and treatment strategies. Quality measures in dental care increasingly focus on the management of periodontal diseases, influencing healthcare utilization patterns and emphasizing the importance of early diagnosis and intervention.

Reimbursement & Billing Impact

Reimbursement considerations include the need for detailed records of clinical findings, treatment plans, and patient compliance. Common denials may arise from insufficient documentation or lack of specificity in coding. To avoid these issues, coders should ensure that all relevant clinical information is captured and that the chosen code accurately reflects the patient's condition. Adhering to coding best practices, including regular updates on coding guidelines and payer policies, is essential for successful billing.

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 K05.30?

K05.30 covers chronic periodontitis that is unspecified, meaning it does not specify whether the condition is localized or generalized. It includes cases where the extent of periodontal attachment loss is not clearly defined.

When should K05.30 be used instead of related codes?

K05.30 should be used when the clinician cannot determine the specific type of chronic periodontitis or when the documentation does not support a more specific code such as K05.31 or K05.32.

What documentation supports K05.30?

Documentation should include clinical findings from periodontal examinations, probing depths, radiographic evidence of bone loss, and a treatment plan that reflects the severity of the disease.