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ICD-10 Guide
ICD-10 CodesK05.311

K05.311

Billable

Chronic periodontitis, localized, slight

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

Code Description

ICD-10 K05.311 is a billable code used to indicate a diagnosis of chronic periodontitis, localized, slight.

Key Diagnostic Point:

Chronic periodontitis, localized, slight, is a common dental condition characterized by the inflammation of the supporting structures of the teeth, primarily the gums, leading to the loss of periodontal attachment and bone. Clinically, it presents with symptoms such as gum swelling, bleeding during brushing, and pockets forming between the teeth and gums. The condition typically affects specific areas of the mouth rather than being generalized. The disease progression can vary; in its slight form, there may be minimal attachment loss and bone resorption. The anatomy involved includes the gingiva, periodontal ligament, and alveolar bone. Diagnostic considerations include clinical examination, probing depths, and radiographic assessment to evaluate bone loss. Early diagnosis and intervention are crucial to prevent progression to more severe forms of periodontitis, which can lead to tooth mobility and loss. Treatment often involves scaling and root planing, along with improved oral hygiene practices.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

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

Audit Risk Factors

  • Common coding errors: Misclassification of the severity of periodontitis.
  • Documentation gaps: Incomplete records of clinical findings and treatment outcomes.
  • Billing challenges: Denials may occur if documentation does not support the diagnosis.

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, particularly in its localized form, has significant implications for oral health and overall well-being. It affects a substantial portion of the population, contributing to tooth loss and impacting quality of life. Effective management of this condition can lead to improved oral hygiene practices and reduced healthcare utilization related to more severe periodontal diseases. Epidemiologically, understanding the prevalence and risk factors associated with chronic periodontitis can inform public health initiatives aimed at prevention and education.

ICD-9 vs ICD-10

Chronic periodontitis, particularly in its localized form, has significant implications for oral health and overall well-being. It affects a substantial portion of the population, contributing to tooth loss and impacting quality of life. Effective management of this condition can lead to improved oral hygiene practices and reduced healthcare utilization related to more severe periodontal diseases. Epidemiologically, understanding the prevalence and risk factors associated with chronic periodontitis can inform public health initiatives aimed at prevention and education.

Reimbursement & Billing Impact

reimbursement considerations include the necessity of scaling and root planing procedures, which may be subject to insurance limitations. It is essential to use the correct CPT codes that correspond to the services provided, and to maintain clear communication with payers regarding the treatment rationale. Regular audits of billing practices can help identify common denial reasons and improve coding accuracy.

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 K05.311?

K05.311 specifically covers localized chronic periodontitis that is classified as slight, indicating minimal attachment loss and inflammation localized to specific teeth or areas.

When should K05.311 be used instead of related codes?

K05.311 should be used when the clinical findings indicate localized chronic periodontitis with slight severity, differentiating it from moderate or generalized forms of periodontitis.

What documentation supports K05.311?

Documentation should include clinical examination findings, probing depths, radiographic evidence of bone loss, and treatment plans that reflect the localized and slight nature of the condition.