Acute tonsillitis (J03) ICD-10-CM
The J03 code range covers acute tonsillitis with 10 ICD-10-CM diagnosis codes. 6 of them are billable and valid for claim submission in fiscal year 2026, and the category headers group them but cannot themselves be billed.
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.
- acute sore throat J02
- hypertrophy of tonsils J35.1
- peritonsillar abscess J36
- sore throat NOS J02.9
- streptococcal sore throat J02.0
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.
- chronic tonsillitis J35.0
Codes in the J03 Range 10 codes · 6 billable
- J03 Acute tonsillitisNon-billable
- J03.0 Streptococcal tonsillitisNon-billable
- J03.00 Acute streptococcal tonsillitis, unspecified
- J03.01 Acute recurrent streptococcal tonsillitis
- J03.8 Acute tonsillitis due to other specified organismsNon-billable
- J03.80 Acute tonsillitis due to other specified organisms
- J03.81 Acute recurrent tonsillitis due to other specified organisms
- J03.9 Acute tonsillitis, unspecifiedNon-billable
- J03.90 Acute tonsillitis, unspecified
- J03.91 Acute recurrent tonsillitis, unspecified
Clinical Terms in This Code Range
Definitions from the National Library of Medicine for conditions coded in the J03 range.
Tonsillitis
Inflammation of the tonsils, especially the PALATINE TONSILS but the ADENOIDS (pharyngeal tonsils) and lingual tonsils may also be involved. Tonsillitis usually is caused by bacterial infection. Tonsillitis may be acute, chronic, or recurrent.
About the J03 Code Range
ICD-10 code J03 covers various forms of acute tonsillitis, an inflammation of the tonsils often caused by bacterial infections. This group includes specific types caused by streptococcal bacteria and other organisms, as well as recurrent and unspecified cases.
The ICD-10 code for acute tonsillitis is J03, and it branches into more detailed codes to help medical coders accurately classify the condition. For example, J03.0 refers specifically to streptococcal tonsillitis, including common synonyms such as "streptococcal sore throat" and "acute bacterial pharyngitis." When the cause is other known bacteria, like staphylococci or fusobacteria, J03.8 or J03.80 are used, encompassing conditions like "necrobacillosis" and "gangrenous tonsillitis." If the tonsillitis recurs frequently, recurrent forms are coded under J03.01 or J03.81, depending on the organism. Cases where the cause is unspecified or not confirmed fall under J03.9 or its subcodes, which cover a variety of synonyms like "suppurative tonsillitis," "acute viral pharyngitis," and "follicular tonsillitis." These codes help healthcare professionals and coders differentiate between bacterial and viral causes, specify recurrence, and accurately document acuity for treatment and billing purposes.
Questions About This Page
How many billable codes are in the J03 range?
Of the 10 codes in this range, 6 are billable and valid for claim submission from October 1, 2025 through September 30, 2026. Category header codes group them but cannot be reported on claims.
What does the J03 range classify?
The range classifies acute tonsillitis. Each code links to its own reference page with billing status, MS-DRG grouping, coding notes, and clinical information.
Related References
Source: CMS FY 2026 ICD-10-CM Tabular List and order file, effective October 1, 2025 through September 30, 2026.
