2026 ICD-10-CM Diagnosis Code K04.4Acute apical periodontitis of pulpal origin

ICD-10-CM CodesK00–K95K00-K14K04

ICD-10-CM K04.4
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

K04.4 is a billable ICD-10-CM diagnosis code for acute apical periodontitis of pulpal origin. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 157 through 159. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Any dental condition including traumatic injury; Caries, periodontitis, and other preventable dental conditions; and Disorders of teeth and gingiva.

Code Identity

ICD-10-CM Code
K04.4
Billable Status
Yes — Valid for Submission
Code Describes
Acute apical periodontitis of pulpal origin
Short Description
Acute apical periodontitis of pulpal origin
Same as the full description in the CMS dataset.
Parent Code
Diseases of pulp and periapical tissues

Code Classification

ChapterK00–K95Diseases of the digestive system
SectionK00-K14Diseases of oral cavity and salivary glands
CategoryK04Diseases of pulp and periapical tissues
This CodeK04.4Acute apical periodontitis of pulpal origin

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Acute apical periodontitis NOS

Type 1 Excludes

  • acute periodontitis K05.2

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Periodontitis(chronic) (complex) (compound) (local) (simplex)
      • apical
        • acute (pulpal origin)
    • Septic
      • teeth, tooth (pulpal origin)

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR DEN001
Any dental condition including traumatic injury
Default principal diagnosis: inpatient No · outpatient No
CCSR DEN003
Caries, periodontitis, and other preventable dental conditions
Default principal diagnosis: inpatient No · outpatient No
CCSR DIG002
Disorders of teeth and gingiva
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR DEN002
Nontraumatic dental conditions
Default principal diagnosis: inpatient No · outpatient No

Patient EducationClinical

Gum Disease

If you have gum disease, you're not alone. Many U.S. adults currently have some form of the disease. It ranges from simple gum inflammation, called gingivitis, to serious damage to the tissue and bone supporting the teeth. In the worst cases, you can lose teeth.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert K04.4 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
522.4 Ac apical periodontitis
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About K04.4Overview

Is K04.4 (Diseases of pulp and periapical tissues) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report acute apical periodontitis of pulpal origin on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does K04.4 group to?

When acute apical periodontitis of pulpal origin is the principal diagnosis on an inpatient stay, it groups to MS-DRG 157, 158, 159, with relative weights from 0.7085 to 1.7168 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of K04.4?

Under the General Equivalence Mappings, acute apical periodontitis of pulpal origin converts to ICD-9-CM 522.4 (ac apical periodontitis). The mapping is a direct match.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.