ICD-10 code for dental sinus

The ICD-10-CM code for dental sinus is K04.6 (Periapical abscess with sinus).

Within K04 (diseases of pulp and periapical tissues), K04.6 is specifically for periapical abscess with sinus. Related codes cover pulpitis (K04.0), necrosis of pulp (K04.1), pulp degeneration (K04.2), abnormal hard tissue formation in pulp (K04.3), acute apical periodontitis of pulpal origin (K04.4), chronic apical periodontitis (K04.5), periapical abscess without sinus (K04.7), Radicular cyst (K04.8) and 1 more.

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 011 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCC, relative weight 5.6154), DRG 012 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CC, relative weight 4.381), DRG 013 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCC, relative weight 2.7307), DRG 157 (Dental and Oral Diseases with MCC, relative weight 1.809), DRG 158 (Dental and Oral Diseases with CC, relative weight 0.9366) and DRG 159 (Dental and Oral Diseases without CC/MCC, relative weight 0.6893), in Pre-MDC and MDC 03 (Diseases and Disorders of the Ear, Nose, Mouth and Throat), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.