J02.9
J02.9: Acute pharyngitis, unspecified
Billable / specific codeICD-10-CM
J02.9 is a billable, specific ICD-10-CM code for acute pharyngitis, unspecified. It is valid for submission on a claim.
Check J02.9 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Gangrenous pharyngitis (acute)
- Infective pharyngitis (acute) NOS
- Pharyngitis (acute) NOS
- Sore throat (acute) NOS
- Suppurative pharyngitis (acute)
- Ulcerative pharyngitis (acute)
Excludes1 inherited from the categories above J02.9
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above J02.9
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with J02.9
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
J02.9 is named in 3 Medicare coverage policies: 3 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A58575Billing and Coding: Respiratory Pathogen Panel Testing
- A58577Billing and Coding: Respiratory Pathogen Panel Testing
- A58741Billing and Coding: Respiratory Pathogen Panel Testing
Alphabetic index entries that lead here
- Faucitis
- Pharyngitis(acute) (catarrhal)(gangrenous) (infective) (malignant) (membranous) (phlegmonous) (pseudomembranous) (simple) (subacute) (suppurative) (ulcerative)
- Necrosis, necrotic›pharynx
- Pharyngitis›purulent
- Pharyngitis›putrid
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative›sore throat
Code history
Unchanged in every release from FY2024 to FY2027.