J35 - Chronic diseases of tonsils and adenoids

Specific Coding for Chronic diseases of tonsils and adenoids

Non-specific codes like J35 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 chronic diseases of tonsils and adenoids:

Patient Education

Adenoids

What are adenoids?

Adenoids are a patch of tissue that is high up in the throat, just behind the nose. They, along with the tonsils, are part of the lymphatic system. The lymphatic system clears away infection and keeps body fluids in balance. The adenoids and tonsils work by trapping germs coming in through the mouth and nose.

Adenoids usually start to shrink after about age 5. By the teenage years, they are almost completely gone. By then, the body has other ways to fight germs.

What are enlarged adenoids?

Enlarged adenoids are adenoids that are swollen. It is a common problem in children.

What causes enlarged adenoids?

Your child's adenoids can be enlarged, or swollen, for different reasons. It may just be that your child had enlarged adenoids at birth. Adenoids can also become enlarged when they are trying to fight off an infection. They might stay enlarged even after the infection is gone.

What problems can enlarged adenoids cause?

Enlarged adenoids can make it hard to breathe through the nose. Your child might end up breathing only through the mouth. This may cause:

• A dry mouth, which can also lead to bad breath
• Cracked lips
• A runny nose

Other problems that enlarged adenoids can cause include:

• Loud breathing
• Snoring
• Restless sleep
• Sleep apnea, a disorder that causes you to repeatedly stop breathing fduring sleep
• Ear infections

How can enlarged adenoids be diagnosed?

To find out if your child has enlarged adenoids, the health care provider will:

• Ask about your child’s medical history, including asking about your child's symptoms
• Check your child's ears, throat, and mouth
• Feel your child's neck

Since the adenoids are higher up than the throat, the provider cannot see them just by looking through your child's mouth. To check the size of your child's adenoids, your provider may use:

• A special mirror in the mouth
• A long, flexible tube with a light (an endoscope)
• An x-ray

What are the treatments for enlarged adenoids?

The treatment depends on what is causing the problem. If the symptoms are not too bad, your child may not need treatment. If treatment is needed, your child may get nasal spray to reduce the swelling or antibiotics if the provider thinks that there is a bacterial infection.

In some cases, your child may need an adenoidectomy.

What is an adenoidectomy and why might I my child need one?

An adenoidectomy is surgery to remove the adenoids. The provider may recommend this surgery if:

• Your child has repeated infections of the adenoids. Sometimes the infections can also cause ear infections and fluid buildup in the middle ear.
• Antibiotics can't get rid of a bacterial infection of the adenoids.
• The enlarged adenoids block the airways.

If there is also a problem with the tonsils, your child will probably have a tonsillectomy (removal of the tonsils) at the same time that the adenoids are removed.

After having the surgery, your child usually goes home the same day. Your child will probably have some throat pain, bad breath, and a runny nose. It can take several days to feel all better.

Code History

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