Is K04.6 a billable ICD-10-CM code?

Yes. K04.6 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does K04.6 sit in the tabular list?

Diseases of the digestive system (K00-K95), in the block Diseases of oral cavity and salivary glands (K00-K14).

K04.6

K04.6 — Periapical abscess with sinus

Billable / specific codeICD-10-CM

K04.6 is a billable, specific ICD-10-CM code for periapical abscess with sinus. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Dental abscess with sinus
Dentoalveolar abscess with sinus

Other codes that can never be billed with K04.6

These codes carry an Excludes1 note pointing at K04.6. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading K04.6 alone.

K05.2Aggressive periodontitis

Risk adjustment

K04.6 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.

How K04.6 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to K04.6.

Fistula›alveolar process
Fistula›dental
Fistula›from periapical abscess
Gumboil›with sinus
Parulis›with sinus
Sinus›dental
Abscess›alveolar›with sinus
Abscess›apical›with sinus(alveolar)
Abscess›dental›with sinus(alveolar)
Abscess›dentoalveolar›with sinus
Abscess›lateral›with sinus
Abscess›periapical›with sinus(alveolar)

Related codes at this level

Codes that share K04. If K04.6 is not quite right, the correct code is usually one of these.

Questions about K04.6

Is K04.6 a billable ICD-10-CM code?: Yes. K04.6 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does K04.6 sit in the tabular list?: Diseases of the digestive system (K00-K95), in the block Diseases of oral cavity and salivary glands (K00-K14).