Is K05.3 a billable ICD-10-CM code?

No. K05.3 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does K05.3 sit in the tabular list?

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

What cannot be coded together with K05.3?

K05.3 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

K05.3

K05.3 — Chronic periodontitis

Non-billable headerICD-10-CM

K05.3 is a non-billable header ICD-10-CM code for chronic periodontitis. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

chronic apical periodontitis (K04.5)

Inclusion terms

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

Chronic pericoronitis
Complex periodontitis
Periodontitis NOS
Simplex periodontitis

Other codes that can never be billed with K05.3

These codes carry an Excludes1 note pointing at K05.3. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading K05.3 alone.

K04.5Chronic apical periodontitis

Risk adjustment

K05.3 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 K05.3

3 child codes. Green means billable.

Related codes at this level

Codes that share K05. If K05.3 is not quite right, the correct code is usually one of these.

Questions about K05.3

Is K05.3 a billable ICD-10-CM code?: No. K05.3 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does K05.3 sit in the tabular list?: Diseases of the digestive system (K00-K95), in the block Diseases of oral cavity and salivary glands (K00-K14).
What cannot be coded together with K05.3?: K05.3 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.