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2025 ICD-10-CM code K04.7

Periapical abscess without sinus; a dental abscess without a visible opening to the surface.

Accurate coding requires careful assessment of the presence or absence of a sinus tract.Radiographic imaging is crucial for confirmation.

Medical necessity for coding K04.7 is established by the presence of a periapical abscess indicated by clinical findings and radiographic evidence.Treatment is necessary to alleviate pain, prevent spread of infection, and preserve the tooth whenever possible. If the tooth is non-restorable, extraction is medically necessary.

Diagnosis and treatment of dental infections, including radiographic imaging, pain management, and potential endodontic (root canal) or surgical procedures.May involve referral to an oral surgeon or endodontist.

IMPORTANT:Related codes include K04.6 (periapical abscess with sinus), K04.0-K04.5 (various conditions of the pulp and periapical tissues), and potentially codes from other chapters depending on complications or associated conditions.

In simple words: This code describes a dental infection (abscess) at the tip of a tooth's root.The infection hasn't broken through to the surface of the gum.

K04.7 in the ICD-10-CM classification system denotes a periapical abscess without a sinus tract.This indicates a localized collection of pus at the apex (tip) of the tooth root, without an external opening or fistula. The infection is confined to the periapical region, typically causing pain and inflammation.

Example 1: A patient presents with severe tooth pain and swelling in the area of a molar. Radiographic examination reveals a periapical abscess without a sinus tract. The dentist diagnoses K04.7 and initiates treatment with antibiotics and possible root canal therapy., A patient reports a long history of chronic tooth pain.Radiographs reveal a periapical abscess without a sinus.After several failed attempts at conservative treatment, the dentist decides on extraction of the affected tooth., A patient with a known history of periodontal disease experiences a sudden onset of severe pain in a previously treated tooth. The radiograph displays a periapical abscess without sinus formation.The dentist performs an apicoectomy (surgical removal of the infected root tip).

* Patient history including symptoms (pain, swelling, tenderness to percussion).* Clinical examination findings (oral examination, palpation).* Radiographic imaging (periapical radiograph) showing the abscess.* Documentation of treatment plan and procedures performed.* Documentation of any related systemic conditions affecting the patient’s healing (diabetes, immunosuppression etc).

** Further investigation may be necessary to identify the underlying cause of the infection and rule out other contributing factors.

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