What is the ICD-10 code for a periapical abscess without sinus involvement?

The ICD-10 code for a periapical abscess without sinus involvement is K04.7. It is used when the abscess does not extend into the sinus.

How do you code a periapical abscess with sinus involvement?

For a periapical abscess with sinus involvement, use ICD-10 code K04.6 and include J01.90 for acute sinusitis if applicable.

ICD-10 Coding for Oral Infection(K04.7, J01.90, K04.0)

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Explore detailed ICD-10 coding guidelines for oral infections, including periapical abscesses with and without sinus involvement. Learn about documentation requirements and coding pitfalls.

Also known as:

Mouth InfectionDental Infection

Related ICD-10 Code Ranges

Complete code families applicable to Oral Infection

K00-K95Primary Range

Diseases of the digestive system

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Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

Code	Description	When to Use	Key Documentation
K04.7	Periapical abscess without sinus	Use when a periapical abscess is confirmed without sinus involvement.	Localized swelling Percussion pain Periapical radiolucency on X-ray
K04.6	Periapical abscess with sinus	Use when a periapical abscess extends into the sinus.	Sinus pain Purulent nasal discharge Radiographic sinus opacification

Primary ICD-10-CM Codes

Periapical abscess without sinus

K04.7Billable

Differential Codes

Alternative codes to consider when ruling out similar conditions

Periapical abscess with sinusK04.6

Periapical abscess without sinusK04.7

Documentation & Coding Risks

Avoid these common issues when documenting Oral Infection.

Vague documentation of tooth pain

Impact

Clinical: May lead to incorrect diagnosis and treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.

Mitigation

Use specific terminology., Include diagnostic test results.

Coding K04.6 without J01.90

Impact

Reimbursement: May result in reduced reimbursement if not coded correctly., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data representation of patient condition.

Mitigation

Add J01.90 as a secondary code when sinus involvement is present.

Documentation of sinus involvement

Impact

Failure to document sinus involvement can lead to incorrect coding.

Mitigation

Ensure imaging and clinical findings are documented.

Frequently Asked Questions

Documentation requirements, coding pitfalls and FAQs for conditions coded with K04.7.

Primary Code

K04.7

Periapical abscess without sinus

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ICD-10 codes5

Coding risks3

FAQs2

ICD-10 Coding for Oral Infection(K04.7, J01.90, K04.0)

Documentation & Coding Risks

Frequently Asked Questions

What is the ICD-10 code for a periapical abscess without sinus involvement?

How do you code a periapical abscess with sinus involvement?

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