Not all e53s have the pairing button inside the center console (especially if you don't have a phone installed). You would need to use the talking head button on the steering wheel...and you'll also need to have BMW ASSIST or the premium pkg.
And yes...you will need the PK (pass key) code BEFORE you'll be able to pair your BT phone to the X5. Once you know you have all the essentials installed plus the PK code...it only requires following the simple instructions exactly as they are given to pair the two together:
(
HINT:
KL R &
KL 15 = ignition position 1 & 2
STEP 3 - requires that you turn your mobile phone's BT search on to look for the X5)

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