J39.1 — Other abscess of pharynx
J39.1 is a billable, specific ICD-10-CM code for other abscess of pharynx. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Cellulitis of pharynx
- Nasopharyngeal abscess
Other codes that can never be billed with J39.1
These codes carry an Excludes1 note pointing at J39.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading J39.1 alone.
- J02Acute pharyngitis
Risk adjustment
J39.1 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
J39.1 is named in 2 Medicare coverage policies — 2 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
How J39.1 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 J39.1.
- Abscess›fauces
- Abscess›nasopharyngeal
- Abscess›pharynx, pharyngeal(lateral)
- Abscess›throat
- Bursitis›pharyngeal
- Cellulitis›nasopharynx
- Cellulitis›pharynx
- Abscess›bursa›pharyngeal
Related codes at this level
Codes that share J39. If J39.1 is not quite right, the correct code is usually one of these.
Questions about J39.1
- Is J39.1 a billable ICD-10-CM code?
- Yes. J39.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does J39.1 sit in the tabular list?
- Diseases of the respiratory system (J00-J99), in the block Other diseases of upper respiratory tract (J30-J39).