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J03.00

Billable

Acute streptococcal tonsillitis, unspecified

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

What This Code Means

This code describes a sudden infection of the tonsils caused by streptococcal bacteria, where the specific type of streptococcus has not been identified. It's a common throat infection that typically causes pain, swelling, and difficulty swallowing.

Coding Tips

  • Use this code only when streptococcal infection is confirmed but the specific streptococcal organism (Group A, Group B, etc.) is not documented; if the organism is specified, use a more specific J03.0x code
  • Verify documentation supports 'acute' presentation; if the condition is chronic or recurrent, different codes (J35.01) may apply instead

Code Hierarchy

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