J02.9 — Acute pharyngitis, unspecified
J02.9 is a billable, specific ICD-10-CM code for acute pharyngitis, unspecified. It is valid for submission on a claim.
Excludes1 — 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)
Other codes that can never be billed with J02.9
These codes carry an Excludes1 note pointing at J02.9. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading J02.9 alone.
Risk adjustment
J02.9 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
J02.9 is named in 3 Medicare coverage policies — 3 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A58575Billing and Coding: Respiratory Pathogen Panel Testing
- A58577Billing and Coding: Respiratory Pathogen Panel Testing
- A58741Billing and Coding: Respiratory Pathogen Panel Testing
How J02.9 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to J02.9.
- Faucitis
- Pharyngitis(acute) (catarrhal)(gangrenous) (infective) (malignant) (membranous) (phlegmonous) (pseudomembranous) (simple) (subacute) (suppurative) (ulcerative) (viral)
- Necrosis, necrotic›pharynx
- Pharyngitis›purulent
- Pharyngitis›putrid
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative›sore throat
Related codes at this level
Codes that share J02. If J02.9 is not quite right, the correct code is usually one of these.
Questions about J02.9
- Is J02.9 a billable ICD-10-CM code?
- Yes. J02.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does J02.9 sit in the tabular list?
- Diseases of the respiratory system (J00-J99), in the block Acute upper respiratory infections (J00-J06).
- What cannot be coded together with J02.9?
- J02.9 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.