J02 — Acute pharyngitis
J02 is a non-billable header ICD-10-CM code for acute pharyngitis. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- chronic pharyngitis (J31.2)
Includes
Conditions this code covers.
- acute sore throat
Other codes that can never be billed with J02
These codes carry an Excludes1 note pointing at J02. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading J02 alone.
Risk adjustment
J02 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead J02
3 child codes. Green means billable.
Questions about J02
- Is J02 a billable ICD-10-CM code?
- No. J02 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does J02 sit in the tabular list?
- Diseases of the respiratory system (J00-J99), in the block Acute upper respiratory infections (J00-J06).
- What cannot be coded together with J02?
- J02 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.