K05.6 ICD-10-CM Code: Periodontal disease, unspecified
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the digestive system (K00-K95) / Diseases of oral cavity and salivary glands (K00-K14)
K05.6
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePeriodontal disease, unspecified
A general diagnosis of gum disease when the specific type or severity is not documented or determined.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for K05.6 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for K05.6 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for K05.6 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for K05.6 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for K05.6 in this effective period.
Use Additional
Official- code to identify:
- alcohol abuse and dependence (F10.-)
- exposure to environmental tobacco smoke (Z77.22)
- exposure to tobacco smoke in the perinatal period (P96.81)
- history of tobacco dependence (Z87.891)
Code Also
OfficialICD-10-CM does not list Code Also instructions for K05.6 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is K05.6 an HCC code?
No. K05.6 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
K05.6 is the ICD-10-CM diagnosis code for periodontal disease, unspecified. A general diagnosis of gum disease when the specific type or severity is not documented or determined. K05.6 sits in the ICD-10-CM chapter for diseases of the digestive system (k00-k95), within the section covering diseases of oral cavity and salivary glands (k00-k14).
K05.6 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Use this code only when the specific periodontal condition cannot be identified; query the provider for more specific diagnosis if possible.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for K05.6 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when the specific periodontal condition cannot be identified; query the provider for more specific diagnosis if possible
- •Review clinical notes for signs of gingivitis, periodontitis, or other specific periodontal conditions that would warrant a more specific code