ICD-10 Code K04 – Diseases of pulp and periapical tissues (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code K04 – Diseases of pulp and periapical tissues
What it is
K04 identifies disorders affecting the tooth pulp and the tissues around the root tip. Use it for conditions such as pulp inflammation, pulp death, or periapical disease when documentation supports this category.
Clinical signs
Clinical features vary; refer to documentation. Common findings may include tooth pain, sensitivity to hot or cold, swelling, tenderness to percussion, or radiographic changes near the root apex.
When to use this code
Use K04 when the record clearly documents a pulp or periapical diagnosis rather than a general dental complaint. It may apply to pulpitis, necrosis, abscess, or other periapical conditions if the provider identifies the condition. Check documentation when the note only says “toothache” or “dental infection.”
Do not use for
Do not use this code for gum disease, caries alone, or nonspecific oral pain without a pulp or periapical diagnosis. If the exact condition is unclear, check documentation.
Coding tip
Code the most specific documented pulp or periapical condition, and verify laterality or tooth-specific details only when the record supports them.