Pharyngitis and Strep Throat ICD-10-CM codes

J02.9 is acute pharyngitis unspecified and is the code for a sore throat diagnosed as pharyngitis with no organism identified. Strep throat is J02.0 (streptococcal pharyngitis); the organism is built into the code, so B95.0 is not added. J02.8 covers pharyngitis due to other specified organisms and requires an additional B95 to B97 code. Pharyngitis due to mononucleosis, herpes, or gonococcus is classified to the infection code in chapter 1 instead.

Acute tonsillitis is J03: J03.00 streptococcal, J03.80 other specified organism, and J03.90 unspecified. The fifth character 1 indicates recurrent acute tonsillitis (J03.01, J03.91). When both pharyngitis and tonsillitis are documented as strep, J03.00 captures the tonsillar involvement and J02.0 is not needed.

Chronic pharyngitis is J31.2 and chronic tonsillitis is J35.01. A peritonsillar abscess is J36 and is coded with the tonsillitis when both are present. A positive rapid strep or culture without a diagnosis of pharyngitis does not support J02.0 on its own; the provider must document the condition.