FY2027
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Excludes1 pair

K04.4 vs K05-

K04.4 and K05 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.

The official note, declared on K04.4
acute periodontitis (K05.2-)
K04.4

Acute apical periodontitis of pulpal origin

Billable
Chapter 11
Diseases of the digestive system
Section
K00-K14
Use when the record says
  • Acute apical periodontitis NOS
Indexed under
  • Septic › teeth, tooth (pulpal origin)
  • Periodontitis › apical › acute (pulpal origin)
K05

Gingivitis and periodontal diseases

Not billable
Chapter 11
Diseases of the digestive system
Section
K00-K14

Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027