the correct icd-9-cm procedure code for a tonsillectomy is:

by Jett Haley 6 min read

28.3 Tonsillectomy with adenoidectomy - ICD-9-CM Vol.

How to find a diagnosis code?

Just a quick tip an irritated Neurologist once suggested to me, keep a binder with the following:

  • Emergency Contact information
  • Insurance information
  • Primary Care Doctor’s information
  • Specialist’s information
  • Latest doctor visit notes
  • Latest test results (including labs and x-rays, CT, MRI, etc.)
  • List of all current prescriptions with doses and strengths

More items...

What is the diagnosis code for chronic tonsillitis?

Chronic tonsillitis. J35.01 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM J35.01 became effective on October 1, 2021. This is the American ICD-10-CM version of J35.01 - other international versions of ICD-10 J35.01 may differ.

What is the ICD 10 code for tonsillectomy?


  • Seven episodes in the past year; or
  • Five episodes per year for 2 years; or
  • Three episodes per year for 3 years; and
  • Documentation in the medical record for each episode of sore throat which includes at least one of the following: Temperature greater than 38.3 °C (100.9 °F); or Cervical adenopathy; or ...

What is an example of a diagnosis code?

–Indicates that code identified in the note and code where the note appears cannot be reported together because the 2 conditions cannot occur together Example: E10 Type 1 Diabetes mellitus Excludes1: diabetes mellitus due to underlying condition (E08.-) drug or chemical induced diabetes mellitus (E09.-) gestational diabetes (O24.4-)

What is the ICD 10 PCS code for tonsillectomy?

ICD-10-PCS Code 0CBPXZZ - Excision of Tonsils, External Approach - Codify by AAPC.

What is the procedure code for tonsillectomy?

CPT® Code 42820 in section: Tonsillectomy and adenoidectomy.

What is Procedure code 0009?

MODIFIER 0009: The full fee for the second condition may be charged. RULE 010: When the treatment times of two completely separate and different conditions overlap, the fee shall be the full fee for one condition and 50% of the fee for the other condition.

What is the ICD-9 code for tonsillitis?

J03. 90 converts approximately to ICD-9-CM: 463 - Acute tonsillitis.

What is procedure code 42821?

CPT® Code 42821 in section: Tonsillectomy and adenoidectomy.

Does CPT code 42145 include tonsillectomy?

Historically speaking, the codes for uvulopalatopharyngoplasty (CPT code 42145) and tonsillectomy (CPT code 42826) have been bundled in NCCI since 1/1/2002.

What are ICD coding standards?

International Statistical Classification of Diseases and Related Health Problems (ICD) ICD serves a broad range of uses globally and provides critical knowledge on the extent, causes and consequences of human disease and death worldwide via data that is reported and coded with the ICD.

What do ICD-10 codes mean?

The ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) is a system used by physicians and other healthcare providers to classify and code all diagnoses, symptoms and procedures recorded in conjunction with hospital care in the United States.

What is diagnosis and procedure codes?

ICD-10-CM diagnosis codes provide the reason for seeking health care; ICD-10-PCS procedure codes tell what inpatient treatment and services the patient got; CPT (HCPCS Level I) codes describe outpatient services and procedures; and providers generally use HCPCS (Level II) codes for equipment, drugs, and supplies for ...

What is the ICD-10 code for tonsillitis?

ICD-10 code J03. 90 for Acute tonsillitis, unspecified is a medical classification as listed by WHO under the range - Diseases of the respiratory system .

What is the ICD-10 code for exudative tonsillitis?

ICD-10-CM Diagnosis Code J03 J03.

What is the ICD-10 code for throat irritation?

J02. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM J02.

What is the code for tonsillectomy bleed?

From my understanding code 42960 is for a post tonsillectomy bleed that can be fixed in the office. Code 42961 is when they can't fix it in the office so they send the patient to the hospital. And 42962 is when they take the patient to the OR. But I also read that if cauterization is done the code is 42960 and if suture ligation ...

Does Medicare pay for tonsil bleeds?

Medicare part b will not pay for complications treated in the ED, bedside or in the office. You cannot bill medicare part b patients for control of post op tonsil bleed controlled in the office or the ED.