2025 ICD-10-CM code J01
(Active) Effective Date: N/A Diseases of the respiratory system - Acute upper respiratory infections J00-J99 Diseases of the respiratory system Feed
Acute sinusitis.
Medical necessity is established by the signs, symptoms, and clinical findings supporting the diagnosis of acute sinusitis. Documentation should clearly demonstrate the need for medical intervention.
Physicians diagnose acute sinusitis based on patient symptoms, physical examination, and sometimes imaging studies. They are responsible for determining the appropriate treatment, which may include antibiotics, decongestants, pain relievers, or other therapies.Accurate documentation of the specific sinus affected (if known) is crucial for proper coding.
In simple words: Acute sinusitis is a sudden inflammation or infection of the sinuses, the air-filled spaces within the skull.
Acute sinusitis includes acute abscess of sinus, acute empyema of sinus, acute infection of sinus, acute inflammation of sinus, and acute suppuration of sinus. Use additional code (B95-B97) to identify infectious agent.
Example 1: A patient presents with facial pain, pressure, nasal congestion, and thick yellow discharge. The physician diagnoses acute maxillary sinusitis., A patient with a recent cold develops a headache, fever, and tenderness over the frontal sinuses. Acute frontal sinusitis is diagnosed., A patient experiences nasal congestion, facial pain, and reduced sense of smell, but the physician does not specify which sinus is affected, so acute sinusitis, unspecified, is diagnosed.
Documentation should include the type of sinusitis (if specified), the causative agent (if known), and associated symptoms such as facial pain, nasal congestion, discharge, headache, fever, etc.Any diagnostic tests performed, such as imaging studies, should also be documented.
** Excludes1: sinusitis NOS (J32.9). Excludes2: chronic sinusitis (J32.0-J32.8).
- Payment Status: Active
- Specialties:Otolaryngology, Family Medicine, Internal Medicine, Pediatrics
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