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Home/Diagnosis/ICD-10 Coding for Tonsil Hypertrophy

ICD-10 Coding for Tonsil Hypertrophy

J35.1
J35.3

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

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

Essential facts and insights about ICD-10 Coding for Tonsil Hypertrophy

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:
  • • Presence of hypertrophic tonsils with or without adenoid involvement
documentation:
  • • Size grading and symptom documentation

Applicable To

  • • Tonsillar hypertrophy with adenoid involvement

Important Notes

  • • Ensure documentation specifies both tonsil and adenoid hypertrophy when using J35.1.

Hypertrophy of tonsils with adenoids and sore throat

Billable Code
J35.3
Billable

Diagnostic Criteria

clinical:
  • • Documentation of hypertrophy linked to sore throat
  • • Recurrent throat pain

Applicable To

  • • Tonsillar hypertrophy with sore throat

Important Notes

  • • Ensure linkage between hypertrophy and sore throat is documented.
Ancillary Codes

Additional codes that may be used with this diagnosis

R06.83

Snoring

Use when snoring is documented as a symptom of hypertrophy.

G47.33

Obstructive sleep apnea (adult) (pediatric)

Use when sleep apnea is documented as a result of hypertrophy.

Frequently Asked Questions

What is the ICD-10 code for tonsil hypertrophy?

The ICD-10 code for tonsil hypertrophy is J35.1, used when there is documented hypertrophy of the tonsils, possibly with adenoid involvement.

How is tonsil hypertrophy documented?

Tonsil hypertrophy should be documented with size grading, such as the Brodsky scale, and any associated symptoms like sore throat or sleep apnea.

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