2025 ICD-10-CM code J02
(Active) Effective Date: N/A Diseases of the respiratory system - Acute upper respiratory infections 10 Feed
Acute pharyngitis. Includes acute sore throat.
Medical necessity for the evaluation and treatment of acute pharyngitis is based on the patient's symptoms, clinical findings, and the potential for complications such as peritonsillar abscess or rheumatic fever (especially in cases of streptococcal pharyngitis).
Diagnosis and treatment of acute pharyngitis are typically managed by primary care physicians, family doctors, internists, or pediatricians. In some cases, otolaryngologists (ENT specialists) may be consulted for complicated cases or those requiring specialized procedures.
In simple words: Acute pharyngitis is a sudden inflammation of the pharynx, commonly known as a sore throat.
Acute inflammation of the pharynx. Includes acute sore throat.
Example 1: A 5-year-old child presents with a sudden onset of sore throat, difficulty swallowing, and fever. Upon examination, the pharynx appears red and inflamed. A rapid strep test is performed, which comes back positive, confirming the diagnosis of streptococcal pharyngitis (J02.0)., A 25-year-old adult complains of a scratchy throat, pain with swallowing, and mild headache. Physical examination reveals redness and inflammation of the pharynx, but no exudates or cervical lymphadenopathy.The symptoms are attributed to a viral infection, leading to a diagnosis of acute pharyngitis (J02.9)., A patient with a history of recurrent tonsillitis presents with severe sore throat, fever, and difficulty swallowing.After examination, the physician diagnoses acute pharyngitis (J02).A throat culture is ordered to identify the causative organism and guide appropriate antibiotic therapy if necessary.
Documentation should include details of the onset, duration, and character of symptoms; physical examination findings (including appearance of the pharynx, presence of exudates, cervical lymphadenopathy); results of any diagnostic tests (e.g., rapid strep test, throat culture); and the physician's assessment and plan of care.
** For accurate coding, ensure that documentation clearly distinguishes between acute and chronic pharyngitis, and that any associated conditions (e.g., peritonsillar abscess) are coded separately.
- Specialties:Family Medicine, Internal Medicine, Pediatrics, Otolaryngology
- Place of Service:Office, Urgent Care Facility, Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home, Inpatient Hospital, Outpatient Hospital