Is ICD-10-CM code J03 billable?

No, J03 (Acute tonsillitis) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code J03 belong to?

J03 belongs to Chapter 10 of the ICD-10-CM tabular list: J00–J99 (Diseases of the Respiratory System).

J03Not billable, use a more specific code below

Acute tonsillitis

In Acute upper respiratory infections (J00-J06), chapter 10: Diseases of the Respiratory System

6 billable codes under J03: none are a CC or MCC; none map to an HCC.

Instructional notes

Excludes1: not coded here, use a different code

acute sore throat (J02.-)
hypertrophy of tonsils (J35.1)
peritonsillar abscess (J36)
sore throat NOS (J02.9)
streptococcal sore throat (J02.0)

Excludes2: not included here, code separately if applicable

chronic tonsillitis (J35.0)

Also applies, from Acute upper respiratory infections (J00-J06)

These notes sit on J00-J06 and apply to every code under it, including J03.

Excludes1: not coded here, use a different code

chronic obstructive pulmonary disease with acute lower respiratory infection (J44.0)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers COPD and asthma exacerbations, sequencing of acute respiratory failure, confirmed versus suspected identified influenza, ventilator associated pneumonia, and vaping-related disorders.

Chronic Obstructive Pulmonary Disease [COPD] and Asthma (page 56)
Acute Respiratory Failure (page 56)
Influenza due to certain identified influenza viruses (page 57)
Ventilator associated Pneumonia (page 57)
Vaping-related disorders (page 58)

Read Section I.C.10 (page 56)

All codes under J03

J03 can't be used on a claim. Pick a billable code below; grey headings group them.

J03 MS-DRGs

This code does not group to an MS-DRG as a principal diagnosis.

Other codes that refer to J03

Notes on these codes point to J03.

J35.0 Excludes2: acute tonsillitis (J03.-)
J36 Excludes1: acute tonsillitis (J03.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Tonsillitis

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.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.