2020 ICD-10-CM Diagnosis Code J36

Peritonsillar abscess

    2016 2017 2018 2019 2020 Billable/Specific Code
  • J36 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The 2020 edition of ICD-10-CM J36 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of J36 - other international versions of ICD-10 J36 may differ.
Use Additional
Use Additional Help
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. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • code (B95-B97
    ICD-10-CM Range B95-B97

    Bacterial and viral infectious agents

    Note
    • These categories are provided for use as supplementary or additional codes to identify the infectious agent(s) in diseases classified elsewhere.
    • B95 Streptococcus, Staphylococcus, and Enter...
    • B96 Other bacterial agents as the cause of d...
    • B97 Viral agents as the cause of diseases cl...
    ) to identify infectious agent.
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 J36. 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 tonsillitis (
    ICD-10-CM Diagnosis Code J03
    • 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 orga...
        • J03.80 Acute tonsillitis due to other specified orga...
        • J03.81 Acute recurrent tonsillitis due to other spec...
      • J03.9 Acute tonsillitis, unspecified
        • J03.90 Acute tonsillitis, unspecified
        • J03.91 Acute recurrent tonsillitis, unspecified
    J03.-
    )
  • 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
    )
  • retropharyngeal abscess (
    ICD-10-CM Diagnosis Code J39.0

    Retropharyngeal and parapharyngeal abscess

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Peripharyngeal abscess
    Type 1 Excludes
    • peritonsillar abscess (J36)
    J39.0
    )
  • tonsillitis NOS (
    ICD-10-CM Diagnosis Code J03.9

    Acute tonsillitis, unspecified

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Applicable To
    • Follicular tonsillitis (acute)
    • Gangrenous tonsillitis (acute)
    • Infective tonsillitis (acute)
    • Tonsillitis (acute) NOS
    • Ulcerative tonsillitis (acute)
    J03.9-
    )
Includes
Includes Help
"Includes" further defines, or give examples of, the content of the code or category.
  • abscess of tonsil
  • peritonsillar cellulitis
  • quinsy
The following code(s) above J36 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 J36:
  • 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
Approximate Synonyms
  • Peritonsillar cellulitis
Clinical Information
  • An accumulation of purulent material in the area between the palatine tonsil and its capsule.
ICD-10-CM J36 is grouped within Diagnostic Related Group(s) (MS-DRG v37.0):
  • 011 Tracheostomy for face, mouth & neck diagnoses or laryngectomy with mcc
  • 012 Tracheostomy for face, mouth & neck diagnoses or laryngectomy with cc
  • 013 Tracheostomy for face, mouth & neck diagnoses or laryngectomy without cc/mcc
  • 152 Otitis media and uri with mcc
  • 153 Otitis media and uri without mcc

Convert J36 to ICD-9-CM

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 J36:
  • Type 1 Excludes: J02
    , J03
    , J39.0
    ICD-10-CM Diagnosis Code J02

    Acute pharyngitis

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Includes
    • acute sore throat
    Type 1 Excludes
    • acute laryngopharyngitis (J06.0)
    • peritonsillar abscess (J36)
    • pharyngeal abscess (J39.1)
    • retropharyngeal abscess (J39.0)
    Type 2 Excludes
    • chronic pharyngitis (J31.2)
    ICD-10-CM Diagnosis Code J03

    Acute tonsillitis

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Type 1 Excludes
    • 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
    • chronic tonsillitis (J35.0)
    ICD-10-CM Diagnosis Code J39.0

    Retropharyngeal and parapharyngeal abscess

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Peripharyngeal abscess
    Type 1 Excludes
    • peritonsillar abscess (J36)
  • Type 2 Excludes: K12.2
    ICD-10-CM Diagnosis Code K12.2

    Cellulitis and abscess of mouth

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Cellulitis of mouth (floor)
    • Submandibular abscess
    Type 2 Excludes

Diagnosis Index entries containing back-references to J36:
  • Abscess (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic) L02.91
    ICD-10-CM Diagnosis Code L02.91

    Cutaneous abscess, unspecified

      2016 2017 2018 2019 2020 Billable/Specific Code
    • lingual K14.0
      ICD-10-CM Diagnosis Code K14.0

      Glossitis

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Abscess of tongue
      • Ulceration (traumatic) of tongue
      Type 1 Excludes
      • atrophic glossitis (K14.4)
      • tonsil J36
    • circumtonsillar J36
    • intratonsillar J36
    • peritonsillar J36
    • posttonsillar J36
    • tonsil J36(s) (lingual)
    • tonsillopharyngeal J36
  • Angina (attack) (cardiac) (chest) (heart) (pectoris) (syndrome) (vasomotor) I20.9
    ICD-10-CM Diagnosis Code I20.9

    Angina pectoris, unspecified

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Angina NOS
    • Anginal syndrome
    • Cardiac angina
    • Ischemic chest pain
  • Cellulitis (diffuse) (phlegmonous) (septic) (suppurative) L03.90
    ICD-10-CM Diagnosis Code L03.90

    Cellulitis, unspecified

      2016 2017 2018 2019 2020 Billable/Specific Code
    • peritonsillar J36
    • tonsil J36
  • Cynanche
    • tonsillaris J36
  • Gangrene, gangrenous (connective tissue) (dropsical) (dry) (moist) (skin) (ulcer) I96
    - see also Necrosis
    ICD-10-CM Diagnosis Code I96

    Gangrene, not elsewhere classified

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Gangrenous cellulitis
    Type 1 Excludes
    Type 2 Excludes
    • gangrene in diabetes mellitus (E08-E13 with .52)
    • quinsy J36
  • Hemorrhage, hemorrhagic (concealed) R58
    ICD-10-CM Diagnosis Code R58

    Hemorrhage, not elsewhere classified

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Hemorrhage NOS
    Type 1 Excludes
    • hemorrhage included with underlying conditions, such as:
    • acute duodenal ulcer with hemorrhage (K26.0)
    • acute gastritis with bleeding (K29.01)
    • ulcerative enterocolitis with rectal bleeding (K51.01)
    • peritonsillar tissue J35.8
      ICD-10-CM Diagnosis Code J35.8

      Other chronic diseases of tonsils and adenoids

        2016 2017 2018 2019 2020 Billable/Specific Code
      Applicable To
      • Adenoid vegetations
      • Amygdalolith
      • Calculus, tonsil
      • Cicatrix of tonsil (and adenoid)
      • Tonsillar tag
      • Ulcer of tonsil
      • due to infection J36
  • Peritonsillitis J36
  • Quinsy J36 (gangrenous)

ICD-10-CM Codes Adjacent To J36
J35 Chronic diseases of tonsils and adenoids
J35.0 Chronic tonsillitis and adenoiditis
J35.01 Chronic tonsillitis
J35.02 Chronic adenoiditis
J35.03 Chronic tonsillitis and adenoiditis
J35.1 Hypertrophy of tonsils
J35.2 Hypertrophy of adenoids
J35.3 Hypertrophy of tonsils with hypertrophy of adenoids
J35.8 Other chronic diseases of tonsils and adenoids
J35.9 Chronic disease of tonsils and adenoids, unspecified
J36 Peritonsillar abscess
J37 Chronic laryngitis and laryngotracheitis
J37.0 Chronic laryngitis
J37.1 Chronic laryngotracheitis
J38 Diseases of vocal cords and larynx, not elsewhere classified
J38.0 Paralysis of vocal cords and larynx
J38.00 …… unspecified
J38.01 …… unilateral
J38.02 …… bilateral
J38.1 Polyp of vocal cord and larynx
J38.2 Nodules of vocal cords

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