2022 ICD-10-CM Code J03

Acute tonsillitis

Version 2021

Not Valid for Submission

ICD-10:J03
Short Description:Acute tonsillitis
Long Description:Acute tonsillitis

Code Classification

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

J03 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. The code is not specific and is NOT valid for the year 2022 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.

Specific Coding for Acute tonsillitis

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

  • NON-BILLABLE CODE - J03.0 for Streptococcal tonsillitis
  • BILLABLE CODE - Use J03.00 for Acute streptococcal tonsillitis, unspecified
  • BILLABLE CODE - Use J03.01 for Acute recurrent streptococcal tonsillitis
  • NON-BILLABLE CODE - J03.8 for Acute tonsillitis due to other specified organisms
  • BILLABLE CODE - Use J03.80 for Acute tonsillitis due to other specified organisms
  • BILLABLE CODE - Use J03.81 for Acute recurrent tonsillitis due to other specified organisms
  • NON-BILLABLE CODE - J03.9 for Acute tonsillitis, unspecified
  • BILLABLE CODE - Use J03.90 for Acute tonsillitis, unspecified
  • BILLABLE CODE - Use J03.91 for Acute recurrent tonsillitis, unspecified

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code J03:


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.

Type 2 Excludes

Type 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

Information for Patients


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

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

You should call your health care provider if your child

You should get emergency care right away if your child

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

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

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 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 (First year ICD-10-CM implemented into the HIPAA code set)