ICD-10 Diagnosis Code J03.9

Acute tonsillitis, unspecified

Diagnosis Code J03.9

ICD-10: J03.9
Short Description: Acute tonsillitis, unspecified
Long Description: Acute tonsillitis, unspecified
This is the 2018 version of the ICD-10-CM diagnosis code J03.9

Not Valid for Submission
The code J03.9 is a "header" and not valid for submission for HIPAA-covered transactions.

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

Information for Medical Professionals

Tabular List of Diseases and Injuries
References found for the code J03.9 in the Tabular List of Diseases and Injuries:

  • Inclusion Terms:
    • Follicular tonsillitis (acute)
    • Gangrenous tonsillitis (acute)
    • Infective tonsillitis (acute)
    • Tonsillitis (acute) NOS
    • Ulcerative tonsillitis (acute)

Information for Patients


Tonsillitis

Also called: Tonsil Inflammation

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 gets 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 should I get medical help for my child?

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.

  • Peritonsillar abscess (Medical Encyclopedia)
  • Tonsil and adenoid removal - discharge (Medical Encyclopedia)
  • Tonsillectomy (Medical Encyclopedia)
  • Tonsillitis (Medical Encyclopedia)

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ICD-10 Footnotes

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.

Index of Diseases and Injuries Definitions

  • And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
  • Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
  • Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
  • Type 1 Excludes Notes - 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 Notes - 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.
  • Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
  • Inclusion terms - List of terms is included under some codes. 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.
  • NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
  • NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
  • See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
  • See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
  • 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
  • With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.

Present on Admission
The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement.

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