K04.6 vs K12.2
K04.6 (Periapical abscess with sinus) compared with K12.2 (Cellulitis and abscess of mouth), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. K12.2 carries an Excludes2 note covering K04.6: “periapical abscess (K04.6-K04.7)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| K04.6Periapical abscess with sinus | K12.2Cellulitis and abscess of mouth | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | K00-K95 — Diseases of the Digestive System (K00-K95) | K00-K95 — Diseases of the Digestive System (K00-K95) |
| Definition | Periapical abscess with sinus is a billable ICD-10-CM diagnosis code (K04.6). | Cellulitis and abscess of mouth is a billable ICD-10-CM diagnosis code (K12.2). |
| Includes | Dental abscess with sinus Dentoalveolar abscess with sinus | Cellulitis of mouth (floor) Submandibular abscess |
| Use additional code | — | code to identify: alcohol abuse and dependence (F10.-) exposure to environmental tobacco smoke (Z77.22) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources