Non-Billable / Non-Specific Code
ICD-10-CM K04 is the diagnosis code for Diseases of pulp and periapical tissues. This code falls under the section "Diseases of oral cavity and salivary glands" within Chapter 11 — Diseases of the digestive system (K00-K95). It is a non-billable/non-specific ICD-10-CM code that should not be used for reimbursement. A more specific sub-code is required for billing. Medical coders and healthcare providers use this code to document and classify diagnoses in electronic health records, insurance claims, and clinical databases.
Always refer to the official ICD-10-CM Tabular List for complete coding guidelines. Ensure documentation supports the specificity of the code selected. When in doubt, consult a certified medical coder or the latest CMS guidelines.
Understanding where K04 sits in the ICD-10-CM classification helps ensure proper coding:
No, K04 is a non-billable/non-specific code. You should use a more specific sub-code for billing and reimbursement.
K04 is the ICD-10-CM diagnosis code for "Diseases of pulp and periapical tissues". It is used by healthcare providers to classify and document this condition in medical records and insurance claims.
K04 is located in Section K00-K14 — "Diseases of oral cavity and salivary glands" within Chapter 11 of the ICD-10-CM Tabular List.
K04 has 10 sub-code(s) that provide more specific detail: K04.0, K04.1, K04.2, K04.3, K04.4 and more.
Use K04 when the patients documented diagnosis matches "Diseases of pulp and periapical tissues" and the clinical documentation supports this level of specificity. Always verify with the latest ICD-10-CM guidelines and payer requirements.
The ICD-10-CM code for Diseases of pulp and periapical tissues is K04.
No, K04 is non-billable. Use a more specific sub-code for primary diagnosis billing.
K04 is in Chapter 11 of the ICD-10-CM Tabular List.
Yes, K04 is a valid ICD-10-CM code for the 2026 fiscal year, subject to official CMS updates.