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Dental Pulp and Apical Disease F052

Document
Last amended 
13 November 2018
Current RMA Instruments
Reasonable Hypothesis SOP
3 of 2014
Balance of Probabilities SOP
4 of 2014
Changes from previous Instruments

SOP Bulletin 171

ICD Coding
  • ICD-9-CM Codes: 522.0, 522.1, 522.2, 522.5, 522.7, 522.3, 522.4, 522.6, 522.8
  • ICD-10-AM Codes: K44, K04.1, K04.2, K04.6, K04.7, K04.9
Brief description

Dental pulp disease involves inflammation / infection of the soft inner part of the tooth.  It is this condition for which root canal treatment is required.  The adjacent apex of a tooth may also be involved.

Confirming the diagnosis

Diagnosis requires an opinion from a dentist or copies of contemporary dental records.

Additional diagnoses covered by SOP
  • Acute and chronic apical periodontitis
  • Apical abscess or endodontic abscess or dentoalveolar abscess.
  • Apical cyst
  • Pulp degeneration
  • Pulp necrosis
  • Pulpitis
Conditions excluded from SOP
  • Combined periodontic-endodontic lesions#
  • Chronic periodontitis*

* another SOP applies

# non-SOP condition

Clinical onset

Time of clinical onset should be based on advice from the treating dentist.

Clinical worsening

The presence of clinical worsening beyond the normal course of the disease should be determined based on advice from a dentist.