K04.5 — Chronic apical periodontitis

Billable

Is K04.5 billable?

Yes — K04.5 is billable for FY2027. K04.5 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. K04.5 may be submitted for encounters from October 1, 2026 through September 30, 2027.

K04.5 at a glance

Code	K04.5
Description	Chronic apical periodontitis
Billable	Yes
Code set	ICD-10-CM FY2027
Valid for encounters	October 1, 2026 – September 30, 2027

Which MS-DRGs does K04.5 group to?

K04.5 sits in MDC Pre and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

011Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCCsurgical
012Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CCsurgical
013Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCCsurgical

How is K04.5 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to K04.5. They show the wording a clinician may have documented, which often differs from the Tabular description.

Granuloma › apical
Granuloma › dental
Granuloma › periapical
Infection, infected, infective › periapical (opportunistic)
Periodontitis › apical (chronic) (complex) (compound) (local) (simplex)
Granuloma › pyogenic, pyogenicum › maxillary alveolar ridge

Excludes1 — never code together

The conditions below can never be reported together with K04.5 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

chronic periodontitis (K05.3-)

Inclusion terms

Alternative wording in documentation that is classified to K04.5.

Apical or periapical granuloma
Apical periodontitis NOS

Excludes2 — not included here — inherited from Chapter 11

The conditions below are not part of K04.5, but a patient may have both at the same time. When documentation supports it, K04.5 and the excluded code may both be reported.

certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

How long has K04.5 existed?

K04.5 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

Which codes are confused with K04.5?

ICD-10-CM declares these codes mutually exclusive with K04.5 — exactly one of each pair can be correct for a given encounter.