2020 ICD-10-CM Diagnosis Code J03

Acute tonsillitis

    2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
  • J03 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
  • The 2020 edition of ICD-10-CM J03 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of J03 - other international versions of ICD-10 J03 may differ.
Type 1 Excludes
Type 1 Excludes Help
A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as J03. A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • acute sore throat (
    ICD-10-CM Diagnosis Code J02
    • J02 Acute pharyngitis
      • J02.0 Streptococcal pharyngitis
      • J02.8 Acute pharyngitis due to other specified orga...
      • J02.9 Acute pharyngitis, unspecified
    J02.-
    )
  • hypertrophy of tonsils (
    ICD-10-CM Diagnosis Code J35.1

    Hypertrophy of tonsils

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Enlargement of tonsils
    Type 1 Excludes
    • hypertrophy of tonsils with tonsillitis (J35.0-)
    J35.1
    )
  • peritonsillar abscess (
    ICD-10-CM Diagnosis Code J36

    Peritonsillar abscess

      2016 2017 2018 2019 2020 Billable/Specific Code
    Includes
    • abscess of tonsil
    • peritonsillar cellulitis
    • quinsy
    Type 1 Excludes
    • acute tonsillitis (J03.-)
    • chronic tonsillitis (J35.0)
    • retropharyngeal abscess (J39.0)
    • tonsillitis NOS (J03.9-)
    Use Additional
    • code (B95-B97) to identify infectious agent.
    J36
    )
  • sore throat NOS (
    ICD-10-CM Diagnosis Code J02.9

    Acute pharyngitis, unspecified

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Gangrenous pharyngitis (acute)
    • Infective pharyngitis (acute) NOS
    • Pharyngitis (acute) NOS
    • Sore throat (acute) NOS
    • Suppurative pharyngitis (acute)
    • Ulcerative pharyngitis (acute)
    J02.9
    )
  • streptococcal sore throat (
    ICD-10-CM Diagnosis Code J02.0

    Streptococcal pharyngitis

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Septic pharyngitis
    • Streptococcal sore throat
    Type 2 Excludes
    J02.0
    )
Type 2 Excludes
Type 2 Excludes Help
A type 2 excludes note represents "not included here". A type 2 excludes note indicates that the condition excluded is not part of the condition it is excluded from but a patient may have both conditions at the same time. When a type 2 excludes note appears under a code it is acceptable to use both the code (J03) and the excluded code together.
  • chronic tonsillitis (
    ICD-10-CM Diagnosis Code J35.0

    Chronic tonsillitis and adenoiditis

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Type 2 Excludes
    • acute tonsillitis (J03.-)
    J35.0
    )
The following code(s) above J03 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to J03:
  • J00-J99
    2020 ICD-10-CM Range J00-J99

    Diseases of the respiratory system

    Note
    • When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e.g. tracheobronchitis to bronchitis in J40).
    Type 2 Excludes
    • certain conditions originating in the perinatal period (P04-P96)
    • certain infectious and parasitic diseases (A00-B99)
    • complications of pregnancy, childbirth and the puerperium (O00-O9A)
    • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
    • endocrine, nutritional and metabolic diseases (E00-E88)
    • injury, poisoning and certain other consequences of external causes (S00-T88)
    • neoplasms (C00-D49)
    • smoke inhalation (T59.81-)
    • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
    Use Additional
    • code, where applicable, to identify:
    • exposure to environmental tobacco smoke (Z77.22)
    • exposure to tobacco smoke in the perinatal period (P96.81)
    • history of tobacco dependence (Z87.891)
    • occupational exposure to environmental tobacco smoke (Z57.31)
    • tobacco dependence (F17.-)
    • tobacco use (Z72.0)
    Diseases of the respiratory system
  • J00-J06
    2020 ICD-10-CM Range J00-J06

    Acute upper respiratory infections

    Type 1 Excludes
    • chronic obstructive pulmonary disease with acute lower respiratory infection (J44.0)
    • influenza virus with other respiratory manifestations (J09.X2, J10.1, J11.1)
    Acute upper respiratory infections
Clinical Information
  • An acute inflammation of the tonsils caused by viruses or bacteria. Signs and symptoms include fever, enlargement of the tonsils, difficulty swallowing, and enlargement of the regional lymph nodes.
Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
Code annotations containing back-references to J03:
  • Type 1 Excludes: J36
    ICD-10-CM Diagnosis Code J36

    Peritonsillar abscess

      2016 2017 2018 2019 2020 Billable/Specific Code
    Includes
    • abscess of tonsil
    • peritonsillar cellulitis
    • quinsy
    Type 1 Excludes
    • acute tonsillitis (J03.-)
    • chronic tonsillitis (J35.0)
    • retropharyngeal abscess (J39.0)
    • tonsillitis NOS (J03.9-)
    Use Additional
    • code (B95-B97) to identify infectious agent.
  • Type 2 Excludes: J35.0
    ICD-10-CM Diagnosis Code J35.0

    Chronic tonsillitis and adenoiditis

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Type 2 Excludes
    • acute tonsillitis (J03.-)
ICD-10-CM Codes Adjacent To J03
J01.8 Other acute sinusitis
J01.80 Other acute sinusitis
J01.81 Other acute recurrent sinusitis
J01.9 Acute sinusitis, unspecified
J01.90 Acute sinusitis, unspecified
J01.91 Acute recurrent sinusitis, unspecified
J02 Acute pharyngitis
J02.0 Streptococcal pharyngitis
J02.8 Acute pharyngitis due to other specified organisms
J02.9 Acute pharyngitis, unspecified
J03 Acute tonsillitis
J03.0 Streptococcal tonsillitis
J03.00 Acute streptococcal tonsillitis, unspecified
J03.01 Acute recurrent streptococcal tonsillitis
J03.8 Acute tonsillitis due to other specified organisms
J03.80 Acute tonsillitis due to other specified organisms
J03.81 Acute recurrent tonsillitis due to other specified organisms
J03.9 Acute tonsillitis, unspecified
J03.90 Acute tonsillitis, unspecified
J03.91 Acute recurrent tonsillitis, unspecified
J04 Acute laryngitis and tracheitis

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.