K04.6
Billable codePeriapical abscess with sinus
The ICD-10 code for periapical abscess with sinus is K04.6.
Clinical notes
Also known as
Alternate wording, synonyms, or specific conditions that fall under this code, listed to help confirm you've picked the right one.
- Dental abscess with sinus
- Dentoalveolar abscess with sinus
Documentation support
General coding-documentation guidance — not a substitute for payer-specific requirements or professional coding judgment.
- •As a general rule, code to the highest level of specificity supported by the documentation in the medical record.
Related codes in this category
- K04.0Pulpitisnon-billable header
- K04.1Necrosis of pulp
- K04.2Pulp degeneration
- K04.3Abnormal hard tissue formation in pulp
- K04.4Acute apical periodontitis of pulpal origin
- K04.5Chronic apical periodontitis
- K04.7Periapical abscess without sinus
- K04.8Radicular cyst
- K04.9Other and unspecified diseases of pulp and periapical tissuesnon-billable header
- K04.6Periapical abscess with sinus
ICD-9-CM equivalent
Informational only — GEM mappings are approximate, not guaranteed one-to-one equivalents. Verify before use in billing.
- 5227
Associated MS-DRGs
K04.6 can serve as the principal diagnosis for these Medicare Severity Diagnosis-Related Groups.
Informational only — actual DRG assignment also depends on procedures, complications/comorbidities (CC/MCC), discharge status, and payer-specific rules not reflected here.
- DRG 011Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCC
- DRG 012Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CC
- DRG 013Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCC
- DRG 157Dental and Oral Diseases with MCC
- DRG 158Dental and Oral Diseases with CC
- DRG 159Dental and Oral Diseases without CC/MCC