J35.03 - Chronic tonsillitis and adenoiditis

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Adenoiditis
• Chronic adenoiditis
• Chronic adenotonsillitis
• Chronic disease of tonsils AND/OR adenoids
• Chronic nasopharyngitis
• Chronic pharyngitis
• Chronic tonsillitis

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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.

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.

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)