Date amended:
External
Statements of Principles
Current RMA Instruments

Reasonable Hypothesis SOP

27 of 2022

Balance of Probabilities SOP

28 of 2022

Changes from previous Instruments

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

Periodontitis 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). Periodontitis can lead to the loosening and then the loss of teeth.

Confirming the diagnosis

Diagnosis requires an opinion from a dentist/periodontist or copies of the contemporary dental records.

Additional diagnoses covered by SOP
  • Aggressive periodontitis
  • Chronic periodontitis
  • Necrotising ulcerative periodontitis
  • Peri-implantitis
Conditions excluded from SOP
  • Acute apical periodonitis (of pulp origin)* - Dental pulp and periapical disease SOP
  • Acute pericoronitis#
  • Chronic apical periodontitis* - Dental pulp and periapical disease SOP
  • Chronic pericoronitis#
  • Gingivitis (acute or chronic)*
  • Maxillary and mandibular ostenecrosis#
  • Necrotising gingivitis confined to the gums* - gingivitis SOP
  • Periodontal abscess*

* another SOP applies

# non-SOP condition

Clinical onset

Time of clinical onset should be based on advice from the treating dentist/periodontist.

Clinical worsening

The presence of clinical worsening beyond the normal course of the disease should be determined based on advice from a dentist/periodontist.