ICD-10 Code K04.4 – Acute apical periodontitis of pulpal origin (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code K04.4 – Acute apical periodontitis of pulpal origin
What it is
K04.4 identifies acute inflammation around the root tip of a tooth caused by diseased or necrotic pulp. It is used when the periapical process is the main diagnosis.
Clinical signs
Patients often report localized tooth pain, tenderness to biting, and discomfort on percussion. Clinical features vary; refer to documentation for evidence of pulpal origin and acute apical involvement.
When to use this code
Use K04.4 when the record clearly documents acute apical periodontitis arising from the tooth pulp. It fits dental encounters where the provider identifies periapical inflammation linked to pulpal disease. Check documentation if the note only says tooth pain or abscess without this diagnosis.
Do not use for
Do not use this code for chronic apical periodontitis, gingival disease, or unspecified dental pain. If the source, acuity, or diagnosis is unclear, check documentation.
Coding tip
Assign K04.4 only when the clinician documents both the acute periapical condition and its pulpal origin.