J03.9 — Acute tonsillitis, unspecified
J03.9 is a non-billable header ICD-10-CM code for acute tonsillitis, unspecified. 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.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Follicular tonsillitis (acute)
- Gangrenous tonsillitis (acute)
- Infective tonsillitis (acute)
- Tonsillitis (acute) NOS
- Ulcerative tonsillitis (acute)
Other codes that can never be billed with J03.9
These codes carry an Excludes1 note pointing at J03.9. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading J03.9 alone.
- J36Peritonsillar abscess
Risk adjustment
J03.9 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.
Code to one of these instead J03.9
2 child codes. Green means billable.
Related codes at this level
Codes that share J03. If J03.9 is not quite right, the correct code is usually one of these.
Questions about J03.9
- Is J03.9 a billable ICD-10-CM code?
- No. J03.9 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does J03.9 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 J03.9?
- J03.9 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.