Is K05.1 a billable ICD-10-CM code?

No. K05.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does K05.1 sit in the tabular list?

Diseases of the digestive system (K00-K95), in the block Diseases of oral cavity and salivary glands (K00-K14).

K05.1

K05.1 — Chronic gingivitis

Non-billable headerICD-10-CM

K05.1 is a non-billable header ICD-10-CM code for chronic gingivitis. It cannot be billed on its own: choose one of the more specific child codes below.

Code first

The underlying condition must be sequenced before this code.

, if applicable, diseases of the digestive system complicating pregnancy (O99.61-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Desquamative gingivitis (chronic)
Gingivitis (chronic) NOS
Hyperplastic gingivitis (chronic)
Pregnancy associated gingivitis
Simple marginal gingivitis (chronic)
Ulcerative gingivitis (chronic)

Risk adjustment

K05.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead K05.1

2 child codes. Green means billable.

Related codes at this level

Codes that share K05. If K05.1 is not quite right, the correct code is usually one of these.

Questions about K05.1

Is K05.1 a billable ICD-10-CM code?: No. K05.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does K05.1 sit in the tabular list?: Diseases of the digestive system (K00-K95), in the block Diseases of oral cavity and salivary glands (K00-K14).