Is J03.8 a billable ICD-10-CM code?

No. J03.8 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does J03.8 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 J03.8?

J03.8 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

J03.8

J03.8 — Acute tonsillitis due to other specified organisms

Non-billable headerICD-10-CM

J03.8 is a non-billable header ICD-10-CM code for acute tonsillitis due to other specified organisms. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

diphtheritic tonsillitis (A36.0)
herpesviral pharyngotonsillitis (B00.2)
streptococcal tonsillitis (J03.0)
tuberculous tonsillitis (A15.8)
Vincent's tonsillitis (A69.1)

Use additional code

Add a secondary code to capture the detail described below.

code (B95-B97) to identify infectious agent.

Risk adjustment

J03.8 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.

Code to one of these instead J03.8

2 child codes. Green means billable.

Related codes at this level

Codes that share J03. If J03.8 is not quite right, the correct code is usually one of these.

Questions about J03.8

Is J03.8 a billable ICD-10-CM code?: No. J03.8 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does J03.8 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 J03.8?: J03.8 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.