2020 ICD-10-CM Diagnosis Code K04.6

Periapical abscess with sinus

    2016 2017 2018 2019 2020 Billable/Specific Code
  • K04.6 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 K04.6 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of K04.6 - other international versions of ICD-10 K04.6 may differ.
Applicable To
  • Dental abscess with sinus
  • Dentoalveolar abscess with sinus
The following code(s) above K04.6 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 K04.6:
  • 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
  • Periapical abscess with sinus tract
ICD-10-CM K04.6 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 K04.6 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 K04.6:
  • Type 1 Excludes: K05.2
    ICD-10-CM Diagnosis Code K05.2

    Aggressive periodontitis

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Applicable To
    • Acute pericoronitis
    Type 1 Excludes
    • acute apical periodontitis (K04.4)
    • periapical abscess (K04.7)
    • periapical abscess with sinus (K04.6)
  • Type 2 Excludes: K12.2
    ICD-10-CM Diagnosis Code K12.2

    Cellulitis and abscess of mouth

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Cellulitis of mouth (floor)
    • Submandibular abscess
    Type 2 Excludes

Diagnosis Index entries containing back-references to K04.6:
  • Abscess (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic) L02.91
    ICD-10-CM Diagnosis Code L02.91

    Cutaneous abscess, unspecified

      2016 2017 2018 2019 2020 Billable/Specific Code
    • alveolar K04.7
      ICD-10-CM Diagnosis Code K04.7

      Periapical abscess without sinus

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Dental abscess without sinus
      • Dentoalveolar abscess without sinus
      • with sinus K04.6
    • apical (tooth) K04.7
      ICD-10-CM Diagnosis Code K04.7

      Periapical abscess without sinus

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Dental abscess without sinus
      • Dentoalveolar abscess without sinus
      • with sinus K04.6 (alveolar)
    • dental K04.7
      ICD-10-CM Diagnosis Code K04.7

      Periapical abscess without sinus

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Dental abscess without sinus
      • Dentoalveolar abscess without sinus
      • with sinus K04.6 (alveolar)
    • dentoalveolar K04.7
      ICD-10-CM Diagnosis Code K04.7

      Periapical abscess without sinus

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Dental abscess without sinus
      • Dentoalveolar abscess without sinus
      • with sinus K04.6
    • lateral (alveolar) K04.7
      ICD-10-CM Diagnosis Code K04.7

      Periapical abscess without sinus

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Dental abscess without sinus
      • Dentoalveolar abscess without sinus
      • with sinus K04.6
    • maxilla, maxillary M27.2
      ICD-10-CM Diagnosis Code M27.2

      Inflammatory conditions of jaws

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Osteitis of jaw(s)
      • Osteomyelitis (neonatal) jaw(s)
      • Osteoradionecrosis jaw(s)
      • Periostitis jaw(s)
      • Sequestrum of jaw bone
      Type 2 Excludes
      • osteonecrosis of jaw due to drug (M87.180)
      Use Additional
      • code (W88-W90, X39.0) to identify radiation, if radiation-induced
      • molar (tooth) K04.7
        ICD-10-CM Diagnosis Code K04.7

        Periapical abscess without sinus

          2016 2017 2018 2019 2020 Billable/Specific Code
        Applicable To
        • Dental abscess without sinus
        • Dentoalveolar abscess without sinus
        • with sinus K04.6
    • periapical K04.7
      ICD-10-CM Diagnosis Code K04.7

      Periapical abscess without sinus

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Dental abscess without sinus
      • Dentoalveolar abscess without sinus
      • with sinus K04.6 (alveolar)
    • root, tooth K04.7
      ICD-10-CM Diagnosis Code K04.7

      Periapical abscess without sinus

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Dental abscess without sinus
      • Dentoalveolar abscess without sinus
      • with sinus K04.6 (alveolar)
    • septal, dental K04.7
      ICD-10-CM Diagnosis Code K04.7

      Periapical abscess without sinus

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Dental abscess without sinus
      • Dentoalveolar abscess without sinus
      • with sinus K04.6 (alveolar)
    • tooth, teeth (root) K04.7
      ICD-10-CM Diagnosis Code K04.7

      Periapical abscess without sinus

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Dental abscess without sinus
      • Dentoalveolar abscess without sinus
      • with sinus K04.6 (alveolar)
  • Fistula (cutaneous) L98.8
    ICD-10-CM Diagnosis Code L98.8

    Other specified disorders of the skin and subcutaneous tissue

      2016 2017 2018 2019 2020 Billable/Specific Code
    • alveolar process K04.6
    • dental K04.6
    • from periapical abscess K04.6
  • Gumboil K04.7
    ICD-10-CM Diagnosis Code K04.7

    Periapical abscess without sinus

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Dental abscess without sinus
    • Dentoalveolar abscess without sinus
    • with sinus K04.6
  • Parulis K04.7
    ICD-10-CM Diagnosis Code K04.7

    Periapical abscess without sinus

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Dental abscess without sinus
    • Dentoalveolar abscess without sinus
    • with sinus K04.6
  • Sinus - see also Fistula
    • dental K04.6

ICD-10-CM Codes Adjacent To K04.6
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
K05.1 Chronic gingivitis

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