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Home/Diagnosis/ICD-10 Coding for Gum Pain

ICD-10 Coding for Gum Pain

K05.6
K06.01
G89.29

Complete ICD-10-CM coding and documentation guide for icd-10 coding for gum pain includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Gingival Pain
Periodontal Pain
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Key Information: ICD-10 Coding for Gum Pain

Essential facts and insights about ICD-10 Coding for Gum Pain

Use ICD-10 code K05.6 for periodontal disease, unspecified, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Periodontal disease, unspecified

Billable Code
K05.6
Billable

Diagnostic Criteria

clinical_criteria:
  • • No bone loss on radiographs

Applicable To

  • • Gingivitis
  • • Periodontitis without bone loss

Important Notes

  • • Ensure documentation specifies absence of bone loss.

Localized gingival recession

Non-Billable
K06.01
Non-Billable

Diagnostic Criteria

clinical_criteria:
  • • Recession measurements (e.g., 3mm recession on specific teeth)

Applicable To

  • • Recession in ≤30% of sites

Important Notes

  • • Document specific teeth and recession measurements.

Other chronic pain

Billable Code
G89.29
Billable

Diagnostic Criteria

clinical_criteria:
  • • Pain duration >3 months
  • • Failed conservative treatments

Applicable To

  • • Chronic gum pain

Important Notes

  • • Ensure pain management is documented as primary reason for encounter.
Ancillary Codes

Additional codes that may be used with this diagnosis

G89.29

Other chronic pain

Use as secondary when pain management is the focus.

Frequently Asked Questions

What is the ICD-10 code for gum pain?

The ICD-10 code for gum pain related to generalized inflammation without bone loss is K05.6. For localized gingival recession, use K06.01.

How to document gum pain for ICD-10 coding?

Document specific clinical findings such as bleeding on probing, pocket depths, and presence of plaque to ensure accurate ICD-10 coding.

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