K04.5 vs K05
K04.5 and K05 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on K04.5
chronic periodontitis (K05.3-)
K04.5
Chronic apical periodontitis
Billable
- Chapter 11
- Diseases of the digestive system
- Section
- K00-K14
Use when the record says
- Apical or periapical granuloma
- Apical periodontitis NOS
Indexed under
- Granuloma › apical
- Granuloma › dental
- Granuloma › periapical
- Infection, infected, infective › periapical (opportunistic)
- Periodontitis › apical (chronic) (complex) (compound) (local) (simplex)
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