ICD-10 K05.5
Billable / SpecificOther periodontal diseases
About ICD-10-CM K05.5
ICD-10-CM code K05.5 represents Other periodontal diseases. This is a billable/specific code in the Digestive System chapter (block K05). The 2026 edition of ICD-10-CM K05.5 became effective on October 1, 2025.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under K05.5. Per CMS ICD-10-CM Tabular 2026.
- Combined periodontic-endodontic lesion
- Narrow gingival width (of periodontal soft tissue)
Type 2 Excludes
Not included here, the excluded code is not part of K05.5, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- leukoplakia of gingiva (K13.21)
Medicare LCD Coverage for K05.5
Local Coverage Determinations (LCDs) from CMS MACs that list K05.5 as a covered diagnosis.
Showing top 10 of 15 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing K05.5.
1 Medicare
CPT Codes Commonly Billed with K05.5
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert K05.5 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| K05.5 | 5238 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To K05.5
Other codes in section K00-K14 (Diseases of oral cavity and salivary glands).
ICD-10 K05.5, Billing FAQ
Is ICD-10 code K05.5 billable? +
Yes, K05.5 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to K05.5? +
ICD-10 K05.5 includes: Combined periodontic-endodontic lesion; Narrow gingival width (of periodontal soft tissue).
What codes are Type 2 Excludes for K05.5? +
Type 2 Excludes (may be coded together when both conditions exist): leukoplakia of gingiva (K13.21)
What ICD-9 codes does K05.5 map to? +
Per CMS GEMs, K05.5 maps to ICD-9 codes: 5238. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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