J02.0
BillableStreptococcal pharyngitis
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
A sore throat infection caused by streptococcal bacteria, commonly known as strep throat. This is a contagious bacterial infection that causes pain, inflammation, and difficulty swallowing.
Coding Tips
- •Verify the documentation specifically identifies streptococcal bacteria (Group A Streptococcus is most common) rather than viral pharyngitis, as this distinction is critical for accurate coding
- •Do not use this code if the infection is caused by other organisms; confirm the causative agent is streptococcal before assigning J02.0
Excludes 2 — Not included here, may code separately
- scarlet fever (A38.-)