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A36.1

Billable

Nasopharyngeal diphtheria

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

Diphtheria is a serious bacterial infection that affects the nose and throat area, causing inflammation and a thick membrane to form that can block breathing. This specific type occurs when the infection is localized to the nasopharynx (the upper part of the throat behind the nose).

Coding Tips

  • •Verify documentation specifies nasopharyngeal involvement rather than other diphtheria sites (respiratory, cutaneous, or unspecified) as each has a different code
  • •Diphtheria is a reportable disease in most jurisdictions; ensure proper public health reporting is completed alongside coding

Code Hierarchy

└A36Diphtheria└A36.1Nasopharyngeal diphtheria
└A36.1Nasopharyngeal diphtheria

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