Excludes1 pair
K04.7 vs K05.2-
K04.7 and K05.2 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 K05.2
periapical abscess (K04.7)
K04.7
Periapical abscess without sinus
Billable
- Chapter 11
- Diseases of the digestive system
- Section
- K00-K14
Use when the record says
- Dental abscess without sinus
- Dentoalveolar abscess without sinus
Indexed under
- Gumboil
- Parulis
- Abscess › alveolar
- Abscess › apical (tooth)
- Abscess › dental
K05.2
Aggressive periodontitis
Not billable
- Chapter 11
- Diseases of the digestive system
- Section
- K00-K14
Use when the record says
- Acute pericoronitis
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