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ICD-10 Guide
ICD-10 CodesK04.8

K04.8

Billable

Radicular cyst

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K04.8 is a billable code used to indicate a diagnosis of radicular cyst.

Key Diagnostic Point:

A radicular cyst is a type of odontogenic cyst that arises from the epithelial remnants of the dental lamina or from the inflammation of the pulp tissue. Clinically, it often presents as a painless swelling in the jaw, typically associated with a non-vital tooth. The cyst is usually located at the apex of a tooth root and can lead to bone resorption if left untreated. The anatomy involved includes the maxilla or mandible, where the cyst can cause displacement of teeth and may be detected through radiographic imaging as a well-defined radiolucency. Disease progression can lead to complications such as infection or tooth loss if the cyst becomes large or symptomatic. Diagnostic considerations include clinical examination, radiographic evaluation, and histopathological analysis following surgical intervention. Treatment typically involves enucleation of the cyst and management of the associated dental issues, such as root canal therapy or extraction of the affected tooth.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

Specialty Focus

Medical Specialties

Dentistry

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Oral and Maxillofacial Surgery

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Radicular cysts can significantly impact oral health, leading to complications such as infection and tooth loss if not treated promptly. Their prevalence in the population highlights the importance of early diagnosis and intervention. Effective management of radicular cysts can improve overall dental health outcomes, reduce healthcare utilization, and enhance quality measures in dental care.

ICD-9 vs ICD-10

Radicular cysts can significantly impact oral health, leading to complications such as infection and tooth loss if not treated promptly. Their prevalence in the population highlights the importance of early diagnosis and intervention. Effective management of radicular cysts can improve overall dental health outcomes, reduce healthcare utilization, and enhance quality measures in dental care.

Reimbursement & Billing Impact

Radicular cysts can significantly impact oral health, leading to complications such as infection and tooth loss if not treated promptly. Their prevalence in the population highlights the importance of early diagnosis and intervention. Effective management of radicular cysts can improve overall dental health outcomes, reduce healthcare utilization, and enhance quality measures in dental care.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K04.8?

K04.8 specifically covers radicular cysts, which are associated with non-vital teeth and arise from periapical inflammation. It does not cover other types of odontogenic cysts or lesions.

When should K04.8 be used instead of related codes?

K04.8 should be used when a radicular cyst is diagnosed, particularly when it is confirmed through imaging and clinical examination, differentiating it from other periapical conditions like abscesses or granulomas.

What documentation supports K04.8?

Documentation should include clinical findings, radiographic evidence of the cyst, treatment notes, and any histopathological reports confirming the diagnosis post-surgery.