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J35.1

Billable

Hypertrophy of tonsils

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

What This Code Means

This condition refers to enlarged tonsils (the lymphoid tissues at the back of the throat) that have grown larger than normal. Enlarged tonsils can cause difficulty swallowing, breathing problems, or sleep disturbances.

Coding Tips

  • •Verify whether the hypertrophy is isolated or occurs with adenoid hypertrophy (J35.2) or both (J35.3), as these are separate codes with different clinical implications
  • •Ensure documentation specifies if the enlarged tonsils are causing obstructive symptoms or sleep apnea, as this may affect treatment decisions and justify additional diagnostic codes

Excludes 1 — Do NOT code together

  • hypertrophy of tonsils with tonsillitis (J35.0-)

Code Hierarchy

└J35Chronic diseases of tonsils and adenoids└J35.1Hypertrophy of tonsils
└J35.1Hypertrophy of tonsils

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