The article discusses two common dental conditions — gingivitis and periodontitis — and their ICD-10 codes.
Oral health is the health of the teeth, gums, and the entire oral-facial system. Oral health problems can significantly impact a person’s health and overall wellbeing. According to the World Health Organization (WHO), dental diseases are among the most common chronic diseases worldwide. There are different types of dental problems that can cause pain and discomfort. Maintaining oral hygiene with daily brushing and flossing as well as routine dental exams is important to ensure healthy teeth and gums. Medical billing and coding for dental conditions can be challenging. Today many dental practices rely on professional medical billing companies to report symptoms, diagnoses and treatments of different dental conditions in claims. Experts can help dentists easily manage the coding and claim submission process.
Here are two common dental conditions and their ICD-10 codes –
Gingivitis – One of the most common forms of a gum disease, gingivitis causes swelling, redness and irritation of gingiva – the part of your gum around the base of your teeth. It is estimated that 3 out of 4 Americans suffer from gingivitis during their lifetime. Poor oral hygiene leads to the formation of plaque (a naturally-occurring sticky film containing bacteria) on the surface of teeth that causes inflammation of the surrounding gum tissue. Many people are not aware that they have gingivitis.
In mild cases, there may be no discomfort or noticeable symptoms. Typical symptoms include bright red or purple gums, tender gums, receding and soft gums, pus between teeth and gums, inflammation or swollen gums and halitosis or bad breath. Treatment can reverse the symptoms and prevent the condition from progressing to more serious gum disease. Treatments include – deep cleaning the teeth, antibiotics and surgery. ICD-10 codes for gingivitis include –
- K05 – Gingivitis and periodontal diseases
- K05.0 – Acute gingivitis
- K05.00 – Acute gingivitis, plaque induced
- K05.01 – Acute gingivitis, non-plaque induced
- K05.1 – Chronic gingivitis
- K05.10 – Chronic gingivitis, plaque induced
- K05.11 – Chronic gingivitis, non-plaque induced
Periodontitis – Periodontitis or serious gum disease results when gingivitis is left untreated. The condition damages the soft tissue and destroys the bone that supports the teeth. If left untreated, periodontitis will eventually result in loosening and potential loss of the teeth. According to reports from the Centers for Disease Control and Prevention (CDC), about half of Americans aged 30 years or older have periodontitis. Symptoms include –inflamed or swollen gums, receding gums, pus between the teeth and gums, bad breath and red or purplish gums. Treatment includes – scaling and cleaning (remove plaque and calculus to restore periodontal health), root planing and prescription medications. Options for treating severe cases include flap surgery (pocket reduction surgery), soft tissue grafts, guided tissue regeneration, and bone grafting. ICD-10 codes include –
• K05 – Gingivitis and periodontal diseases
• K05.0 – Acute gingivitis
- K05.00 – Acute gingivitis, plaque induced
- K05.01 – Acute gingivitis, non-plaque induced
• K05.1 – Chronic gingivitis
- K05.10 – Chronic gingivitis, plaque induced
- K05.11 – Chronic gingivitis, non-plaque induced
• K05.2 – Aggressive periodontitis
- K05.20 – Aggressive periodontitis, unspecified
- K05.21 – Aggressive periodontitis, localized
- K05.211 – Aggressive periodontitis, localized slight
- K05.212 – Aggressive periodontitis, localized moderate
- K05.213 – Aggressive periodontitis, localized severe
- K05.219 – Aggressive periodontitis, localized unspecified severity
- K05.22 – Aggressive periodontitis, generalized
- K05.221 – Aggressive periodontitis, generalized, slight
- K05.222 – Aggressive periodontitis, generalized, moderate
- K05.223 – Aggressive periodontitis, generalized, severe
- K05.229 – Aggressive periodontitis, generalized, unspecified severity
• K05.3 – Chronic periodontitis
- K05.30 – Chronic periodontitis, unspecified
- K05.31 – Chronic periodontitis, localized
- K05.311 – Chronic periodontitis, localized, slight
- K05.312 – Chronic periodontitis, localized, moderate
- K05.313 – Chronic periodontitis, localized, severe
- K05.319 – Chronic periodontitis, localized, unspecified severity
- K05.32 – Chronic periodontitis, generalized
- K05.321 – Chronic periodontitis, generalized, slight
- K05.322 – Chronic periodontitis, generalized, moderate
- K05.323 – Chronic periodontitis, generalized, severe
- K05.329 – Chronic periodontitis, generalized, unspecified severity
• K05.4 – Periodontosis
• K05.5 – Other periodontal diseases
• K05.6 – Periodontal disease, unspecified
With annual code updates, varying insurer rules, and the challenges of collecting payment from patients, dental billing and coding can be a challenging process. Partnering with an experienced dental billing company can ensure accurate and timely billing and claim submission.
