K04
K04 — Diseases of pulp and periapical tissues
Non-billable headerICD-10-CM
K04 is a non-billable header ICD-10-CM code for diseases of pulp and periapical tissues. It cannot be billed on its own: choose one of the more specific child codes below.
Other codes that can never be billed with K04
These codes carry an Excludes1 note pointing at K04. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading K04 alone.
Risk adjustment
K04 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead K04
10 child codes. Green means billable.
- K04.0Pulpitis
- K04.1Necrosis of pulp
- K04.2Pulp degeneration
- K04.3Abnormal hard tissue formation in pulp
- K04.4Acute apical periodontitis of pulpal origin
- K04.5Chronic apical periodontitis
- K04.6Periapical abscess with sinus
- K04.7Periapical abscess without sinus
- K04.8Radicular cyst
- K04.9Other and unspecified diseases of pulp and periapical tissues
Questions about K04
- Is K04 a billable ICD-10-CM code?
- No. K04 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does K04 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Diseases of oral cavity and salivary glands (K00-K14).