ICD-10 · PDGM grouping
K04 Diseases of pulp and periapical tissues
All 12 codes in the K04 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
12
Can lead a claim
0
Cannot lead a claim
12
What CMS assigns to K04
None of the 12 codes is assigned a clinical group. None of the 12 is assigned a comorbidity subgroup. None can lead a claim.
Every code in K04
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| K04.0 Pulpitis | ||||
| K04.01 | Reversible pulpitis | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| K04.02 | Irreversible pulpitis | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| K04.1 | Necrosis of pulp | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| K04.2 | Pulp degeneration | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| K04.3 | Abnormal hard tissue formation in pulp | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| K04.4 | Acute apical periodontitis of pulpal origin | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| K04.5 | Chronic apical periodontitis | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| K04.6 | Periapical abscess with sinus | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| K04.7 | Periapical abscess without sinus | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| K04.8 | Radicular cyst | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| K04.9 Other and unspecified diseases of pulp and periapical tissues | ||||
| K04.90 | Unspecified diseases of pulp and periapical tissues | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| K04.99 | Other diseases of pulp and periapical tissues | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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