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Home/Diagnosis/ICD-10 Coding for Periapical Abscess

ICD-10 Coding for Periapical Abscess

K04.6
K04.7

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

Also Known as:
Dental Abscess
Tooth Abscess
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Key Information: ICD-10 Coding for Periapical Abscess

Essential facts and insights about ICD-10 Coding for Periapical Abscess

Use ICD-10 code K04.6 for periapical abscess with sinus, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Periapical abscess with sinus

Billable Code
K04.6
Billable

Diagnostic Criteria

  • • Presence of a draining sinus tract

Applicable To

  • • Periapical abscess with draining sinus
  • • Periapical abscess with fistula

Important Notes

  • • Ensure sinus tract is documented to avoid incorrect coding.

Periapical abscess without sinus

Billable Code
K04.7
Billable

Diagnostic Criteria

  • • Absence of sinus tract or fistula

Applicable To

  • • Periapical abscess without draining sinus

Important Notes

  • • Document absence of sinus tract to ensure correct coding.
Ancillary Codes

Additional codes that may be used with this diagnosis

L02.81

Cutaneous abscess of head/neck

Use if cellulitis is present.

K04.1

Pulp necrosis

Use if pulp necrosis is confirmed.

Frequently Asked Questions

What is the ICD-10 code for periapical abscess?

The ICD-10 code for periapical abscess with sinus is K04.6, and without sinus is K04.7.

How do you code a periapical abscess with a sinus tract?

Code K04.6 is used for a periapical abscess with a documented sinus tract.

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