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ICD-10-CM Code K04.5
Chronic apical periodontitis

BILLABLE
Billable Code
Billable codes are sufficient justification for admission to an acute care hospital when used a principal diagnosis.
| ICD-10 from 2011 - 2016

K04.5 is a billable ICD code used to specify a diagnosis of chronic apical periodontitis. A 'billable code' is detailed enough to be used to specify a medical diagnosis.


The ICD code K045 is used to code Periapical periodontitis

periapical periodontitis (also termed apical periodontitis, ap, or periradicular peridontitis) is an acute or chronic inflammatory lesion around the apex of a tooth root which is caused by bacterial invasion of the pulp of the tooth. the term is derived from peri- meaning "around", apical referring to the apex of the root (the tip of the root), and -itis meaning a disease characterized by inflammation. periapical periodontitis can be considered a sequela in the natural history of dental caries (tooth decay), irreversible pulpitis and pulpal necrosis, since it is the likely outcome of untreated dental caries, although not always. periapical periodontitis may develop into a periapical abscess, where a collection of pus forms at the end of the root, the consequence of spread of infection from the tooth pulp (odontogenic infection), or into a periapical cyst, where an epithelial lined, fluid filled structure forms.

Periapical dental radiograph showing chronic periapical periodontitis on the root of the left maxillary second premolar. Note large restoration present in the tooth, which will have undergone pulpal necrosis at some point before the development of this lesion.

Source: Wikipedia

Coding Notes for K04.5 Info for medical coders on how to properly use this ICD-10 code

Inclusion Terms:
Inclusion Terms
Inclusion Terms are a list of concepts for which a specific code is used. The list of Inclusion Terms is useful for determining the correct code in some cases, but the list is not necessarily exhaustive.
Apical or periapical granuloma
Apical periodontitis NOS
Code Type-1 Excludes:
Type-1 Excludes
Type-1 Excludes mean the conditions excluded are mutually exclusive and should never be coded together. Excludes 1 means "do not code here."
Chronic periodontitis - instead, use code K05.3-

MS-DRG Mapping

  • DRG Group #011-013 - Tracheostomy for face, mouth and neck diagnoses with MCC.
  • DRG Group #011-013 - Tracheostomy for face, mouth and neck diagnoses with CC.
  • DRG Group #011-013 - Tracheostomy for face, mouth and neck diagnoses without CC or MCC.
  • DRG Group #157-159 - Dental and oral diseases with MCC.
  • DRG Group #157-159 - Dental and oral diseases with CC.
  • DRG Group #157-159 - Dental and oral diseases without CC or MCC.

Related Concepts SNOMET-CT

  • Chronic apical periodontitis (disorder)

ICD-10-CM Alphabetical Index References for 'K04.5 - Chronic apical periodontitis'

The ICD-10-CM Alphabetical Index links the below-listed medical terms to the ICD code K04.5. Click on any term below to browse the alphabetical index.

Equivalent ICD-9 Code GENERAL EQUIVALENCE MAPPINGS (GEM)

Chronic apical periodontitis (exact match)

This is the official exact match mapping between ICD9 and ICD10, as provided by the General Equivalency mapping crosswalk. This means that in all cases where the ICD9 code 522.6 was previously used, K04.5 is the appropriate modern ICD10 code.


Parent Code: K04 - Diseases of pulp and periapical tissues

** This Document Provided By ICD.Codes **
Source: http://icd.codes/icd10cm/K045