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Home/Diagnosis/ICD-10 Coding for Enlarged Tonsils

ICD-10 Coding for Enlarged Tonsils

J35.1
J35.0

Complete ICD-10-CM coding and documentation guide for icd-10 coding for enlarged tonsils includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Tonsillar Hypertrophy
Hypertrophy of Tonsils
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Key Information: ICD-10 Coding for Enlarged Tonsils

Essential facts and insights about ICD-10 Coding for Enlarged Tonsils

Use ICD-10 code J35.1 for hypertrophy of tonsils, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Hypertrophy of tonsils

Billable Code
J35.1
Billable

Diagnostic Criteria

clinical:
  • • Tonsil size grading without signs of inflammation
coding:
  • • Absence of chronic tonsillitis documentation

Applicable To

  • • Tonsillar hypertrophy

Important Notes

  • • Ensure documentation specifies hypertrophy without signs of inflammation.

Chronic tonsillitis

Non-Billable
J35.0
Non-Billable

Diagnostic Criteria

clinical:
  • • Duration of symptoms >3 months
  • • Presence of inflammation markers (erythema, exudate)

Applicable To

  • • Chronic inflammation of tonsils

Important Notes

  • • Ensure chronicity and inflammation are documented.
Ancillary Codes

Additional codes that may be used with this diagnosis

Z77.22

Contact with and (suspected) exposure to environmental tobacco smoke

Use when tobacco exposure contributes to hypertrophy.

Frequently Asked Questions

What is the ICD-10 code for enlarged tonsils?

The ICD-10 code for enlarged tonsils without inflammation is J35.1, which indicates hypertrophy of tonsils. Use J35.0- for chronic tonsillitis if inflammation is present.

How to document enlarged tonsils for ICD-10 coding?

Document tonsil size using a grading scale and note the absence or presence of inflammation to ensure accurate ICD-10 coding.

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