What is the ICD-10 code for a tooth abscess with a sinus?

The ICD-10 code for a tooth abscess with a sinus is K04.6. This code is used when a sinus tract is present with the abscess.

How do you code a tooth abscess without a sinus?

For a tooth abscess without a sinus, use ICD-10 code K04.7. Ensure documentation confirms the absence of a sinus tract.

ICD-10 Coding for Tooth Abscess(K04.6, K04.7, K05.6)

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Learn about ICD-10 coding for tooth abscesses, including codes K04.6 and K04.7, documentation requirements, and common pitfalls.

Also known as:

Dental AbscessPeriapical AbscessDentoalveolar Abscess

Related ICD-10 Code Ranges

Complete code families applicable to Tooth Abscess

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
K04.6	Periapical abscess with sinus	Use when a sinus tract is present with the abscess.	Presence of draining sinus tract Imaging showing lesion extending to sinus
K04.7	Periapical abscess without sinus	Use when no sinus tract is present with the abscess.	Absence of sinus tract Imaging showing localized periapical lesion

Primary ICD-10-CM Codes

Periapical abscess with sinus

K04.6Billable

Differential Codes

Alternative codes to consider when ruling out similar conditions

Periapical abscess without sinusK04.7

Periapical abscess with sinusK04.6

Documentation & Coding Risks

Avoid these common issues when documenting Tooth Abscess.

Failing to document sinus tract

Impact

Clinical: Misdiagnosis of abscess type, Regulatory: Potential audit triggers, Financial: Claim denials or reduced reimbursement

Mitigation

Use standardized templates, Cross-check documentation with imaging

Confusing K04.6 with K04.7

Impact

Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.

Mitigation

Verify and document the presence or absence of a sinus tract.

Sinus Tract Documentation

Impact

Lack of documentation for sinus tract presence can lead to audits.

Mitigation

Ensure thorough documentation and imaging confirmation.

Frequently Asked Questions

Documentation requirements, coding pitfalls and FAQs for conditions coded with K04.6.

Primary Code

K04.6

Periapical abscess with sinus

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ICD-10 codes3

Coding risks3

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ICD-10 Coding for Tooth Abscess(K04.6, K04.7, K05.6)

Documentation & Coding Risks

Frequently Asked Questions

What is the ICD-10 code for a tooth abscess with a sinus?

How do you code a tooth abscess without a sinus?

Related condition guides