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J03.80

Billable

Acute tonsillitis due to other specified organisms

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 bacteria or other organisms that are not the most common causes (like strep or staph). It's used when the specific organism causing the sore throat and inflamed tonsils has been identified but doesn't fit into the more common categories.

Coding Tips

  • Use this code only when the causative organism has been documented and identified as something other than Group A Streptococcus, Staphylococcus aureus, or other commonly specified organisms
  • Ensure the documentation specifies both that the tonsillitis is acute and identifies the specific organism responsible; if the organism is not documented, use a less specific code like J03.90

Code Hierarchy

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