J39.0 — Retropharyngeal and parapharyngeal abscess
J39.0 is a billable, specific ICD-10-CM code for retropharyngeal and parapharyngeal abscess. 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.
- peritonsillar abscess (J36)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Peripharyngeal abscess
Other codes that can never be billed with J39.0
These codes carry an Excludes1 note pointing at J39.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading J39.0 alone.
Risk adjustment
J39.0 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
J39.0 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.
- A56729Billing and Coding: Magnetic Resonance Imaging of the Head and Neck
- A56868Billing and Coding: Outpatient Speech Language Pathology
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
How J39.0 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 J39.0.
- Abscess›parapharyngeal
- Abscess›peripharyngeal
- Abscess›postpharyngeal
- Abscess›retropharyngeal
Related codes at this level
Codes that share J39. If J39.0 is not quite right, the correct code is usually one of these.
Questions about J39.0
- Is J39.0 a billable ICD-10-CM code?
- Yes. J39.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does J39.0 sit in the tabular list?
- Diseases of the respiratory system (J00-J99), in the block Other diseases of upper respiratory tract (J30-J39).
- What cannot be coded together with J39.0?
- J39.0 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.