Periapical abscess with sinus

This code signifies an acute or chronic infection originating from the pulp of a tooth, extending into the periapical tissues, and characterized by the formation of a purulent exudate that has created a drainage pathway (sinus tract) to the oral cavity or skin. It represents a localized collection of pus at the apex of a tooth root, with an established fistula.

Apply this code when documentation clearly indicates a periapical abscess with evidence of a draining sinus tract. This typically includes clinical findings such as a visible fistula, purulent discharge, and radiographic evidence of periapical radiolucency. Use for both acute and chronic presentations where a sinus is present.

• Differentiate from periapical abscess without sinus (522.6) or cellulitis of the mouth (528.3).
• Ensure documentation specifies the presence of a "sinus" or "fistula" for accurate coding.
• Consider sequencing with codes for underlying dental caries (521.0-521.9) or pulpitis (522.0-522.2) if applicable and documented.