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A trick to understand what codes to use when billing!

After the patient has had a clinical, many diagnostic tests are now used in our Oral Wellness practices.



3.Oral DNA

4.Saliva Metor from Cari Free

Doctor can order these tests when the team has gathered the patients medical history over the phone so he can then order any tests on day one of the patients appointment.

First we all need to understand that each patient will have a differnt diagnosis with different treatment and medical history.

Periodontitis (gum disease) is infection and inflammation of the gums, which causes damage to the bone of the teeth. Whereas chronic periodontitis is more common and manifests in adults, aggressive (acute) periodontitis presents during anywhere from childhood to early adulthood. Pericoronitis, which is gum inflammation around partially erupted teeth (teeth which are just beginning to surface), most often occurs around wisdom teeth and is classified in ICD-10-CM under “Periodontitis”.

Periodontitis can be localized or generalized:

  • Localized, involving one or two permanent teeth
  • Generalized, involving three or more permanent teeth

Periodontitis is further classified into three types:

  • Slight: Also referred to as “early”. Slight bone loss apparent, and the gums are becoming inflamed and separating from the teeth. With loss of soft tissue and bone, pockets (spaces) begin to form, creating an ideal environment for bacteria to thrive.
  • Moderate: Moderate bone loss apparent, causing the teeth to become loose. Gums begin to recede. Pockets become even larger. 
  • Severe: Severe bone loss renders the teeth to be extremely loose and/or fall out. Pockets may be filled with pus and extra teeth may need to be extracted.
  1. Without the classifications billing will not be strong and bills will not be paid.
  2. Without the patients medical health backing up the treatment it has not become a medical necessissity.

Our billing requires knowledge on what the numbers in the code stand for.

What to Document
4th Character: Type of gingivitis or periodontitis
5th Character: Localized or generalized
6th Character: Severity

– Any alcohol abuse and dependence
– Any tobacco use, dependence, history of dependence, exposure to tobacco smoke in the perinatal period, or exposure to environmental tobacco smoke, occupational or otherwise

Periodontitis: A serious gum infection that damages the gums and destroys the jawbone
Periodontosis: Considered an outdated diagnosis by many professionals, defined as a noninflammatory degeneration of bone causing bone loss and extrusion
Try to find a diagnostic code with a 6th Character
Document:  Severity
Applies to: K05.21-
Including: Periodontal abscess




Unspecified severity

Applies to: K05.22-




Unspecified severity
Try hard to find a code without the 0 or 9 ending the code.

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