2025 ICD-10-CM code K04.4
(Active) Effective Date: N/A Diseases of the digestive system - Diseases of pulp and periapical tissues Diseases of the digestive system (K00-K95) Feed
Acute apical periodontitis stemming from pulpal origin.This condition encompasses acute periapical periodontitis not otherwise specified (NOS).
Medical necessity for treatment related to K04.4 is established by the presence of signs and symptoms of acute apical periodontitis. The documentation must clearly demonstrate the severity of the condition and its impact on the patient's oral health. The chosen treatment approach, whether root canal therapy, extraction, or other interventions, should be justified based on the individual patient's clinical presentation and the dentist's professional judgment.
Dentists and other oral healthcare professionals are responsible for diagnosing and managing acute apical periodontitis of pulpal origin. This involves assessing the patient's symptoms, conducting a clinical examination, taking radiographs, and determining the appropriate treatment plan. Treatment may include root canal therapy, antibiotics, pain management, and/or extraction of the affected tooth.
In simple words: This code represents an acute infection at the root tip of your tooth, originating from an infection inside the tooth itself.
Acute apical periodontitis of pulpal origin refers to the inflammation of the tissues surrounding the apex (tip) of a tooth root, specifically resulting from infection or inflammation within the dental pulp. The dental pulp contains nerves, blood vessels, and connective tissue, and when it becomes infected or inflamed, the inflammatory process can extend to the periapical tissues. This can lead to pain, swelling, and potentially the formation of an abscess.
Example 1: A patient presents with severe throbbing pain in a lower molar. Clinical examination and radiographs reveal an inflamed area around the root tip, consistent with acute apical periodontitis. The dentist determines that the inflammation originated from an infected pulp within the tooth., A patient experiences pain and swelling in the gums around an upper incisor. Following a dental examination and radiographic imaging, a diagnosis of acute apical periodontitis is made. The infection is traced back to a previous pulp injury that allowed bacteria to enter the tooth., A patient reports spontaneous pain in a premolar. Diagnostic tests indicate the presence of acute apical periodontitis. The dentist determines that the inflammation is a consequence of a deep cavity that extended into the pulp, leading to infection and subsequent periapical inflammation.
Documentation for K04.4 should include clinical findings such as pain, swelling, tenderness to percussion or palpation, and presence of a sinus tract. Radiographic evidence of periapical radiolucency is typically required. The documentation should also indicate the origin of the inflammation within the dental pulp, such as caries, trauma, or previous dental procedures.
** Excludes1: acute periodontitis (K05.2-)
- Specialties:Endodontics, General Dentistry
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center