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J01 ICD-10-CM Code: Acute sinusitis

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FY 2026 Apr update / Diseases of the respiratory system (J00-J99) / Acute upper respiratory infections (J00-J06)

J01

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Acute sinusitis

Acute sinusitis

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
J0Acute upper respiratory infections (J00-J06)
J01Acute sinusitis

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for J01 in this effective period.

Excludes 2

Official
  • chronic sinusitis (J32.0-J32.8)

Related Child Codes

Official
J01.0Acute maxillary sinusitis
J01.1Acute frontal sinusitis
J01.2Acute ethmoidal sinusitis
J01.3Acute sphenoidal sinusitis
J01.4Acute pansinusitis

Includes

Official
  • acute abscess of sinus
  • acute empyema of sinus
  • acute infection of sinus
  • acute inflammation of sinus
  • acute suppuration of sinus

Excludes 1

Official
  • sinusitis NOS (J32.9)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for J01 in this effective period.

Use Additional

Official
  • code (B95-B97) to identify infectious agent.

Code Also

Official

ICD-10-CM does not list Code Also instructions for J01 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

J01 is the ICD-10-CM diagnosis code for acute sinusitis. J01 sits in the ICD-10-CM chapter for diseases of the respiratory system (j00-j99), within the section covering acute upper respiratory infections (j00-j06).

Header codes like J01 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at J01's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for J01 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • acute abscess of sinus
  • acute empyema of sinus
  • acute infection of sinus
  • acute inflammation of sinus
  • acute suppuration of sinus

Excludes 1, Do NOT code together

Excludes 2, Not included here, may code separately

Use Additional Code

  • code (B95-B97) to identify infectious agent.

Child Codes

Code Hierarchy

J01Acute sinusitis
J01Acute sinusitis

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