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2025 ICD-10-CM code J03.9

Acute tonsillitis, unspecified.

When multiple respiratory conditions are present, code to the lowest anatomical site. Additional codes should be used to specify causal organisms, contributing factors, and tobacco exposure history, as applicable.

Medical necessity for treatment of acute tonsillitis is determined by the presence of significant symptoms such as severe sore throat, difficulty swallowing, high fever, and dehydration.The severity of symptoms will guide treatment decisions, including antibiotic use.

Diagnosis and management of acute tonsillitis, which may include physical examination, throat culture, and treatment decisions (e.g., antibiotics, supportive care).

IMPORTANT:Excludes1: acute sore throat (J02.-), hypertrophy of tonsils (J35.1), peritonsillar abscess (J36), sore throat NOS (J02.9), streptococcal sore throat (J02.0). Excludes2: chronic tonsillitis (J35.0)

In simple words: This code is for a sudden tonsil infection where the doctor hasn't specified the exact kind of infection.It covers different types of sudden tonsil infections.

This code represents acute tonsillitis without specification of the type.It encompasses various forms of acute tonsillitis, including follicular, gangrenous, infective, and ulcerative tonsillitis.The term "NOS" (not otherwise specified) indicates a lack of further detail regarding the specific type of tonsillitis.

Example 1: A 5-year-old presents with a sore throat, fever, and difficulty swallowing. Physical examination reveals enlarged, red tonsils with white spots (follicular tonsillitis).A rapid strep test is negative.The physician diagnoses acute tonsillitis, unspecified, and prescribes symptomatic treatment., A 20-year-old college student complains of severe sore throat, high fever, and difficulty swallowing for 2 days.Exam reveals severely swollen tonsils with a grayish-white membrane (suggestive of a more severe infection).A throat culture is taken, and the patient is started on antibiotics pending results. The diagnosis is acute tonsillitis, unspecified., A 40-year-old adult presents with a mild sore throat and slight fever, which he's had for a few days. Physical exam reveals mildly enlarged, erythematous tonsils.The physician diagnoses acute tonsillitis, unspecified, and recommends rest and hydration.

Detailed history of present illness, including symptom onset, duration, severity, and associated symptoms (e.g., fever, cough, difficulty swallowing).Physical examination findings, including description of tonsils (size, color, presence of exudate or membrane).Results of any diagnostic tests (e.g., rapid strep test, throat culture).

** This code should be used when the specific type of acute tonsillitis cannot be determined.Further investigation may be required to identify the causative organism and guide appropriate treatment.

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