2024 ICD-10-CM Diagnosis Code J03.9

Acute tonsillitis, unspecified

ICD-10-CM Code:
J03.9
ICD-10 Code for:
Acute tonsillitis, unspecified
Is Billable?
Not Valid for Submission
Code Navigator:

Code Classification

  • Diseases of the respiratory system
    (J00–J99)
    • Acute upper respiratory infections
      (J00-J06)
      • Acute tonsillitis
        (J03)

J03.9 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of acute tonsillitis, unspecified. The code is not specific and is NOT valid for the year 2024 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Unspecified diagnosis codes like J03.9 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

Specific Coding Applicable to Acute tonsillitis, unspecified

Non-specific codes like J03.9 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for acute tonsillitis, unspecified:

  • Use J03.90 for Acute tonsillitis, unspecified - BILLABLE CODE

  • Use J03.91 for Acute recurrent tonsillitis, unspecified - BILLABLE CODE

Clinical Information

  • Acute Tonsillitis

    an acute inflammation of the tonsils caused by viruses or bacteria. signs and symptoms include fever, enlargement of the tonsils, difficulty swallowing, and enlargement of the regional lymph nodes.

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.


Inclusion Terms

Inclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
  • Follicular tonsillitis (acute)
  • Gangrenous tonsillitis (acute)
  • Infective tonsillitis (acute)
  • Tonsillitis (acute) NOS
  • Ulcerative tonsillitis (acute)

Type 1 Excludes

Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.

Patient Education


Tonsillitis

What are tonsils?

Tonsils are lumps of tissue at the back of the throat. There are two of them, one on each side. Along with the adenoids, tonsils are part of the lymphatic system. The lymphatic system clears away infection and keeps body fluids in balance. Tonsils and adenoids work by trapping the germs coming in through the mouth and nose.

What is tonsillitis?

Tonsillitis is an inflammation (swelling) of the tonsils. Sometimes along with tonsillitis, the adenoids are also swollen.

What causes tonsillitis?

The cause of tonsillitis is usually a viral infection. Bacterial infections such as strep throat can also cause tonsillitis.

Who is at risk for tonsillitis?

Tonsillitis is most common in children over age two. Almost every child in the United States gets it at least once. Tonsillitis caused by bacteria is more common in kids ages 5-15. Tonsillitis caused by a virus is more common in younger children.

Adults can get tonsillitis, but it is not very common.

Is tonsillitis contagious?

Although tonsillitis is not contagious, the viruses and bacteria that cause it are contagious. Frequent handwashing can help prevent spreading or catching the infections.

What are the symptoms of tonsillitis?

The symptoms of tonsillitis include:

  • A sore throat, which may be severe
  • Red, swollen tonsils
  • Trouble swallowing
  • A white or yellow coating on the tonsils
  • Swollen glands in the neck
  • Fever
  • Bad breath

When does my child need to see a health care provider for tonsillitis?

You should call your health care provider if your child:

  • Has a sore throat for more than two days
  • Has trouble or pain when swallowing
  • Feels very sick or very weak

You should get emergency care right away if your child:

  • Has trouble breathing
  • Starts drooling
  • Has a lot of trouble swallowing

How is tonsillitis diagnosed?

To diagnose tonsillitis, your child's health care provider will first ask you about your child's symptoms and medical history. The provider will look at your child's throat and neck, checking for things such as redness or white spots on the tonsils and swollen lymph nodes.

Your child will probably also have one or more tests to check for strep throat, since it can cause tonsillitis and it requires treatment. It could be a rapid strep test, a throat culture, or both. For both tests, the provider uses a cotton swab to collect a sample of fluids from your child's tonsils and the back of the throat. With the rapid strep test, testing is done in the office, and you get the results within minutes. The throat culture is done in a lab, and it usually takes a few days to get the results. The throat culture is a more reliable test. So sometimes if the rapid strep test is negative (meaning that it does not show any strep bacteria), the provider will also do a throat culture just to make sure that your child does not have strep.

What are the treatments for tonsillitis?

Treatment for tonsillitis depends on the cause. If the cause is a virus, there is no medicine to treat it. If the cause is a bacterial infection, such as strep throat, your child will need to take antibiotics. It is important for your child to finish the antibiotics even if he or she feels better. If treatment stops too soon, some bacteria may survive and re-infect your child.

No matter what is causing the tonsillitis, there are some things you can do to help your child feel better. Make sure that your child:

  • Gets a lot of rest
  • Drinks plenty of fluids
  • Tries eating soft foods if it hurts to swallow
  • Tries eating warm liquids or cold foods like popsicles to soothe the throat
  • Isn't around cigarette smoke or do anything else that could irritate the throat
  • Sleeps in a room with a humidifier
  • Gargles with saltwater
  • Sucks on a lozenge (but do not give them to children under four; they can choke on them)
  • Takes an over-the-counter pain reliever such as acetaminophen. Children and teenagers should not take aspirin.

In some cases, your child may need a tonsillectomy.

What is a tonsillectomy and why might my child need one?

A tonsillectomy is surgery to remove the tonsils. Your child might need it if he or she:

  • Keeps getting tonsillitis
  • Has bacterial tonsillitis that does not get better with antibiotics
  • Has tonsils are too big, and are causing trouble breathing or swallowing

Your child usually gets the surgery and goes home later that day. Very young children and people who have complications may need to stay in the hospital overnight. It can take a week or two before your child completely recovers from the surgery.


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Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.