K04

Non-Billable
ChapterK00–K95
Rankcategory
Official Description

Diseases of pulp and periapical tissues

Metadata & Insights
  • Non-billable category (requires more specific sub-code).
  • Chapter 11: Diseases of the Digestive System (K00-K95).

CH11 Parent Instructions

Excludes2(Not included here. Code separately if applicable.)
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Clinical Hierarchy

BillableHas subcodes
CH11Diseases of the digestive system (K00-K95)
K00-K14Diseases of oral cavity and salivary glands (K00-K14)
K04Diseases of pulp and periapical tissuesNot billable
K04.0PulpitisSubcodes
K04.1Necrosis of pulpBillable
K04.2Pulp degenerationBillable
K04.3Abnormal hard tissue formation in pulpBillable
K04.4Acute apical periodontitis of pulpal originBillable
K04.5Chronic apical periodontitisBillable
K04.6Periapical abscess with sinusBillable
K04.7Periapical abscess without sinusBillable
K04.8Radicular cystBillable
K04.9Other and unspecified diseases of pulp and periapical tissuesSubcodes

Applicable Ancestor Context

The following parent sections contain instructions or notes that apply to K04:

chapterCH11
Diseases of the digestive system (K00-K95)
View context instructions

MS-DRG Classification

2026

No direct MS-DRG triggers identified.

Cross Reference

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