Coding, Classification and Reimbursement

Acute phryngotonsilitis

  • 1.  Acute phryngotonsilitis

    Posted 26 days ago
    Dear Team,

    May I know ICD-10CM code for Acute Pharynotonsilitis code. I am getting B00.2 and getting denied from insurance. patient has fever, cough, vomiting, no known allergies. kindly let me know correct code for this case. or else only acute tonsillitis code can be report to avoid rejection from the insurance.

    thanks

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    Shankara Papaiah Narasimha
    Clinical Coding Auditor
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  • 2.  RE: Acute phryngotonsilitis

    Posted 21 days ago
    I would not code with B00.2  Herpesviral gingivostomatisis and pharyngotonsillitis unless there is documentation that the organism is Herpes viral.  In Alphabetic Index Pharyngotonsillitis, herpesviral - the herpesviral is not in parentheses so we would not treat it as a non-essential modifier.

    Without knowing the organism I would code J03.90 Acute tonsillitis, unspec. and J02.9 Acute pharyngitis, unspec.
    What You Need to Know About Tonsillitis in Adults
    Hopkinsmedicine remove preview
    What You Need to Know About Tonsillitis in Adults
    Pharyngitis and tonsillitis are infections that cause inflammation. If the tonsils are affected, it is called tonsillitis. If the throat is affected, it is called pharyngitis. If you have both, it's called pharyngotonsillitis. These infections are spread by close contact with others. Most cases happen during the winter or colder months.
    View this on Hopkinsmedicine >


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    Kathy Completa
    Coding and Documentation Educator
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  • 3.  RE: Acute phryngotonsilitis

    Posted 20 days ago
    Thank you very much

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    Shankara Papaiah Narasimha
    Clinical Coding Auditor
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