ICD-10 Code for Tooth Infection
The ICD-10 code for a tooth infection depends on the specific type and location, but the most commonly used codes are K04.7 (periapical abscess without sinus), K04.6 (periapical abscess with sinus), and K05.21 (aggressive periodontitis with abscess).
Primary Diagnostic Codes
The specific ICD-10 code assignment requires identifying the exact nature and anatomic location of the dental infection 1:
- K04.7 - Periapical abscess without sinus tract (most common for acute tooth abscess)
- K04.6 - Periapical abscess with sinus tract (when drainage pathway present)
- K05.21 - Aggressive periodontitis with abscess (gingival/periodontal origin)
- K04.4 - Acute apical periodontitis of pulpal origin
- K04.5 - Chronic apical periodontitis
Clinical Context for Code Selection
When selecting the appropriate ICD-10 code, document the following clinical features to ensure accurate coding 1:
- Affected tooth location (maxillary vs. mandibular; specific tooth number) - mandibular and maxillary first molars are the most frequently affected teeth in odontogenic infections 1
- Presence or absence of abscess formation - approximately 50% present as inflammatory infiltrates and 50% as abscesses 1
- Duration of symptoms and whether systemic involvement exists (fever, malaise, lymphadenopathy) 2
- Presence of sinus tract or fistula formation 1
Important Coding Considerations
The ICD-10-CM code set uses only 4 of a possible 7 characters for dental diagnoses, which limits specificity 3. For clinical documentation purposes, include detailed narrative descriptions alongside the code to capture the full clinical picture 3.
Double-check code accuracy, especially when documenting complex odontogenic infections, as the hierarchical structure of ICD-10 codes can make finding the most accurate code challenging 4, 5.
Common Pitfalls
- Avoid using nonspecific codes like K04.9 (unspecified disease of pulp and periapical tissues) when more specific information is available 1
- Do not confuse periapical infections (K04.x codes) with periodontal infections (K05.x codes) - these represent different disease processes requiring different treatment approaches 2, 6
- Document whether the infection has spread to adjacent structures, as this affects both coding and treatment decisions 6