K04.6 Periapical abscess with sinus

The ICD-10-CM code for Periapical abscess with sinus is K04.6 (FY2026). It is a billable, claim-ready diagnosis code.

Classification

Chapter

11: Diseases of the digestive system (K00-K95)

Section

K00-K14: Diseases of oral cavity and salivary glands (K00-K14)

Category K04

15 codes (12 billable)

FY2026 Status

Stable since FY2024

Also Known As

ICD-10-CM Alphabetic Index entries that lead to K04.6:

• Sinus › dental
• Fistula (cutaneous) › alveolar process
• Fistula (cutaneous) › dental
• Gumboil › with sinus
• Parulis › with sinus
• Fistula (cutaneous) › from periapical abscess
• Abscess (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic) › apical (tooth) › with sinus (alveolar)
• Abscess (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic) › alveolar › with sinus

Inclusion Terms

• Dental abscess with sinus
• Dentoalveolar abscess with sinus

U.S. Hospital Utilization

• An estimated 625 U.S. inpatient stays in 2023 included K04.6 among the documented diagnoses.
• 225 stays listed it as the principal diagnosis.

Source: National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality, 2016–2023. National survey-weighted estimates.

Official Coding Guidelines

Chapter 11 reserved for future expansion

11. Chapter 11: Diseases of the Digestive System (K00-K95) Reserved for future guideline expansion

Source: CMS — ICD-10-CM Official Guidelines for Coding and Reporting, FY2026

References

• CMS — ICD-10-CM Official Code Set and Guidelines, FY2026
• CDC/NCHS — ICD-10-CM Files and Browser Tool
• AHRQ — HCUP National Inpatient Sample, Frequencies by Diagnosis Code (2016–2023)