2025 ICD-10-CM code J39.1
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Respiratory System - Other diseases of upper respiratory tract Diseases of the respiratory system Feed
Other abscess of the pharynx.
Modifiers may be applicable depending on the circumstances of the encounter and the services provided. Consult your local coding guidelines for specific instructions on modifier usage.
Medical necessity for coding J39.1 is established by the presence of a clinically significant pharyngeal abscess requiring medical or surgical intervention.The symptoms should warrant treatment to prevent potential complications, such as airway compromise or sepsis.
The clinical responsibility involves diagnosis and treatment of the pharyngeal abscess. This may include physical examination, imaging studies (such as CT scan or ultrasound), aspiration of the abscess, and antibiotic therapy.Surgical intervention might be necessary in certain cases.
In simple words: This code is for a pus-filled infection (abscess) in the back of your throat.This area connects your mouth and nose to your windpipe and esophagus. You might have a fever or trouble swallowing.
This code classifies an abscess located in the pharynx (the back of the throat) that is not specifically categorized elsewhere.It encompasses various types of abscesses, such as those that are connective tissue, embolic, fistulous, infective, metastatic, multiple, pernicious, pyogenic, or septic.The abscess may present with symptoms such as high fever and difficulty swallowing.
Example 1: A 35-year-old patient presents with severe sore throat, difficulty swallowing, and a high fever. Physical examination reveals a palpable mass in the pharynx. Imaging confirms a peritonsillar abscess. , A 60-year-old patient with a history of chronic alcoholism develops a retropharyngeal abscess after aspiration of food. The patient presents with neck pain, fever, and dyspnea., A 20-year-old patient with a history of recent tonsillectomy develops a pharyngeal abscess at the site of the surgical incision. The patient presents with pain and swelling at the surgical site.
Detailed history and physical examination, including the location and size of the abscess.Imaging studies (such as CT scan or ultrasound) to confirm the diagnosis.Complete blood count (CBC) and other relevant laboratory tests. Documentation of treatment rendered (e.g., incision and drainage, antibiotic therapy).
** This code should not be used for abscesses located in other areas of the respiratory tract.Always ensure proper documentation to support the diagnosis and treatment.
- Payment Status: Active
- Specialties:Otolaryngology, Infectious Disease
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Emergency Room - Hospital