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Periodontitis F011

Last amended 
26 June 2015
Current RMA Instruments:
Reasonable Hypothesis SOP
47 of 2013
Balance of Probabilities SOP
48 of 2013
Changes from Previous Instruments:

SOP Bulletin 166

ICD Coding:
  • ICD-9-CM Codes: 523.4
  • ICD-10-AM Codes: K05.3

This is inflammation of the periodontium which is the ligament which attaches the teeth to the bony sockets. The periodontium is normally covered by the overlying gingiva (gums). This can lead to the loosening and then the loss of teeth.

Is specific diagnostic evidence required to apply the SOP?No.

The relevant medical specialist is a dentist or oral surgeon.

Are there sub-factors that require specific information? – No.
Additional diagnoses covered by SOP
  • Aggressive periodontitis
  • Chronic periodontitis
  • Necrotising ulcerative periodontitis
  • Peri-implantitis
Conditions excluded from SOP
  • Acute apical periodonitis (of pulp origin), ICD-9-CM 522.4
  • Acute pericoronitis, use ICD-9-CM code 523.9
  • Acute periodontitis, obsolete term, either ICD-9-CM code 522.4, 523.3 or 523.9
  • Chronic apical periodontitis, ICD-9-CM code 522.6
  • Chronic pericoronitis, use ICD-9-CM code 523.9
  • Gingivitis (acute or chronic), ICD-9-CM codes 523.0-1, 101
  • Maxillary and mandibular ostenecrosis
  • Necrotising gingivitis confined to the gums, ICD-9-CM code 101
  • Periodontal abscess, ICD-9-CM code 523.3
Unconfirmed diagnosis

If, after applying the above information, you are unable to confirm the diagnosis, you should then:

  1. seek medical officer advice about further investigation, or;
  2. generate a diagnostic report, or;
  3. re-encode the condition, if appropriate.

The following investigations may be useful in establishing the diagnosis.

  • Report from a dentist.