2020 ICD-10-CM Diagnosis Code K04.5

Chronic apical periodontitis

    2016 2017 2018 2019 2020 Billable/Specific Code
  • K04.5 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The 2020 edition of ICD-10-CM K04.5 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of K04.5 - other international versions of ICD-10 K04.5 may differ.
Applicable To
  • Apical or periapical granuloma
  • Apical periodontitis NOS
Type 1 Excludes
Type 1 Excludes Help
A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as K04.5. A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • chronic periodontitis (
    ICD-10-CM Diagnosis Code K05.3

    Chronic periodontitis

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Applicable To
    • Chronic pericoronitis
    • Complex periodontitis
    • Periodontitis NOS
    • Simplex periodontitis
    Type 1 Excludes
    • chronic apical periodontitis (K04.5)
    K05.3-
    )
The following code(s) above K04.5 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to K04.5:
  • K00-K95
    2020 ICD-10-CM Range K00-K95

    Diseases of the digestive system

    Type 2 Excludes
    • certain conditions originating in the perinatal period (P04-P96)
    • certain infectious and parasitic diseases (A00-B99)
    • complications of pregnancy, childbirth and the puerperium (O00-O9A)
    • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
    • endocrine, nutritional and metabolic diseases (E00-E88)
    • injury, poisoning and certain other consequences of external causes (S00-T88)
    • neoplasms (C00-D49)
    • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
    Diseases of the digestive system
Approximate Synonyms
  • Marginal periodontitis
Clinical Information
  • Inflammation of the periapical tissue. It includes general, unspecified, or acute nonsuppurative inflammation. Chronic nonsuppurative inflammation is periapical granuloma. Suppurative inflammation is periapical abscess.
ICD-10-CM K04.5 is grouped within Diagnostic Related Group(s) (MS-DRG v37.0):
  • 011 Tracheostomy for face, mouth & neck diagnoses or laryngectomy with mcc
  • 012 Tracheostomy for face, mouth & neck diagnoses or laryngectomy with cc
  • 013 Tracheostomy for face, mouth & neck diagnoses or laryngectomy without cc/mcc
  • 157 Dental and oral diseases with mcc
  • 158 Dental and oral diseases with cc
  • 159 Dental and oral diseases without cc/mcc

Convert K04.5 to ICD-9-CM

Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
Code annotations containing back-references to K04.5:
  • Type 1 Excludes: K05.3
    ICD-10-CM Diagnosis Code K05.3

    Chronic periodontitis

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Applicable To
    • Chronic pericoronitis
    • Complex periodontitis
    • Periodontitis NOS
    • Simplex periodontitis
    Type 1 Excludes
    • chronic apical periodontitis (K04.5)
  • Type 2 Excludes: L98.0
    ICD-10-CM Diagnosis Code L98.0

    Pyogenic granuloma

      2016 2017 2018 2019 2020 Billable/Specific Code
    Type 2 Excludes
    • pyogenic granuloma of gingiva (K06.8)
    • pyogenic granuloma of maxillary alveolar ridge (K04.5)
    • pyogenic granuloma of oral mucosa (K13.4)

Diagnosis Index entries containing back-references to K04.5:
  • Granuloma L92.9
    ICD-10-CM Diagnosis Code L92.9

    Granulomatous disorder of the skin and subcutaneous tissue, unspecified

      2016 2017 2018 2019 2020 Billable/Specific Code
    Type 2 Excludes
    • pyogenic, pyogenicum (of) (skin) L98.0
      ICD-10-CM Diagnosis Code L98.0

      Pyogenic granuloma

        2016 2017 2018 2019 2020 Billable/Specific Code
      Type 2 Excludes
      • pyogenic granuloma of gingiva (K06.8)
      • pyogenic granuloma of maxillary alveolar ridge (K04.5)
      • pyogenic granuloma of oral mucosa (K13.4)
      • maxillary alveolar ridge K04.5
    • apical K04.5
    • dental K04.5
    • periapical K04.5
  • Infection, infected, infective (opportunistic) B99.9
    ICD-10-CM Diagnosis Code B99.9

    Unspecified infectious disease

      2016 2017 2018 2019 2020 Billable/Specific Code
    • periapical K04.5
  • Periodontitis (chronic) (complex) (compound) (local) (simplex) K05.30
    ICD-10-CM Diagnosis Code K05.30

    Chronic periodontitis, unspecified

      2016 2017 2018 2019 2020 Billable/Specific Code

ICD-10-CM Codes Adjacent To K04.5
K03.89 Other specified diseases of hard tissues of teeth
K03.9 Disease of hard tissues of teeth, unspecified
K04 Diseases of pulp and periapical tissues
K04.0 Pulpitis
K04.01 Reversible pulpitis
K04.02 Irreversible pulpitis
K04.1 Necrosis of pulp
K04.2 Pulp degeneration
K04.3 Abnormal hard tissue formation in pulp
K04.4 Acute apical periodontitis of pulpal origin
K04.5 Chronic apical periodontitis
K04.6 Periapical abscess with sinus
K04.7 Periapical abscess without sinus
K04.8 Radicular cyst
K04.9 Other and unspecified diseases of pulp and periapical tissues
K04.90 Unspecified diseases of pulp and periapical tissues
K04.99 Other diseases of pulp and periapical tissues
K05 Gingivitis and periodontal diseases
K05.0 Acute gingivitis
K05.00 …… plaque induced
K05.01 …… non-plaque induced

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.