2025 ICD-10-CM code K04.7
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of oral cavity and salivary glands - Diseases of pulp and periapical tissues Diseases of the digestive system Feed
Periapical abscess without sinus; a dental abscess without a visible opening to the surface.
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.
- Diseases of the digestive system
- K00-K95 (Diseases of the digestive system) > K00-K14 (Diseases of oral cavity and salivary glands) > K04 (Diseases of pulp and periapical tissues)
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.
- Payment Status: Active
- Specialties:Dentistry, Oral and Maxillofacial Surgery, Endodontics
- Place of Service:Office, Hospital Outpatient Department