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Home/Diagnosis/ICD-10 Coding for Tonsillopharyngitis

ICD-10 Coding for Tonsillopharyngitis

J03.90
J03.01

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

Also Known as:
Sore throat
Tonsillitis and pharyngitis
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Key Information: ICD-10 Coding for Tonsillopharyngitis

Essential facts and insights about ICD-10 Coding for Tonsillopharyngitis

Use ICD-10 code J03.90 for acute tonsillitis, unspecified, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Acute tonsillitis, unspecified

Billable Code
J03.90
Billable

Diagnostic Criteria

clinical:
  • • Presence of tonsillar exudate
  • • Tender anterior cervical lymphadenopathy
  • • Positive rapid strep test
documentation:
  • • Detailed history and physical examination findings

Applicable To

  • • Acute tonsillopharyngitis

Important Notes

  • • Ensure documentation specifies acute vs. chronic and identifies the organism when possible.

Acute recurrent streptococcal tonsillitis

Billable Code
J03.01
Billable

Diagnostic Criteria

clinical:
  • • Recurrent episodes documented
  • • Positive rapid strep test or culture
  • • ASO titer >200 IU/mL

Applicable To

  • • Recurrent streptococcal tonsillopharyngitis

Important Notes

  • • Document each episode's frequency and confirmatory tests.
Ancillary Codes

Additional codes that may be used with this diagnosis

B95.0

Streptococcus, group A, as the cause of diseases classified elsewhere

Use to specify the organism causing the tonsillopharyngitis.

Z87.19

Personal history of other diseases of the respiratory system

Use to indicate a history of recurrent tonsillopharyngitis.

Frequently Asked Questions

What is the ICD-10 code for tonsillopharyngitis?

The ICD-10 code for unspecified acute tonsillopharyngitis is J03.90, while J03.01 is used for acute recurrent streptococcal tonsillitis.

How do you code recurrent tonsillopharyngitis?

Recurrent tonsillopharyngitis is coded as J03.01 when caused by streptococcus, with an additional code B95.0 for the organism.

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