K05.5 — Other periodontal diseases
K05.5 is a billable, specific ICD-10-CM code for other periodontal diseases. It is valid for submission on a claim.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- leukoplakia of gingiva (K13.21)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Combined periodontic-endodontic lesion
- Narrow gingival width (of periodontal soft tissue)
Risk adjustment
K05.5 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.
Medicare coverage
K05.5 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56767Billing and Coding: Heavy Metal Testing
How K05.5 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to K05.5.
- Lesion›combined periodontic - endodontic
- Lesion›periodontal, due to traumatic occlusion
- Narrow›gingival width(of periodontal soft tissue)
- Disease, diseased›periodontal›specified NEC
- Occlusion, occluded›traumatic›periodontal
Related codes at this level
Codes that share K05. If K05.5 is not quite right, the correct code is usually one of these.
Questions about K05.5
- Is K05.5 a billable ICD-10-CM code?
- Yes. K05.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K05.5 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Diseases of oral cavity and salivary glands (K00-K14).