J31.1 — Chronic nasopharyngitis
J31.1 is a billable, specific ICD-10-CM code for chronic nasopharyngitis. It is valid for submission on a claim.
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.
- acute nasopharyngitis (J00)
Risk adjustment
J31.1 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.
Medicare coverage
J31.1 is named in 8 Medicare coverage policies — 8 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
- A57473Billing and Coding: Allergy Testing
- A57473Billing and Coding: Allergy Testing
- A60360Billing and Coding: Allergy Diagnostic Testing
How J31.1 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to J31.1.
- Atrophy, atrophic›nasopharynx
- Catarrh, catarrhal›nasobronchial
- Catarrh, catarrhal›nasopharyngeal(chronic)
- Nasopharyngitis›chronic(suppurative) (ulcerative)
- Rhinopharyngitis›chronic
Related codes at this level
Codes that share J31. If J31.1 is not quite right, the correct code is usually one of these.
Questions about J31.1
- Is J31.1 a billable ICD-10-CM code?
- Yes. J31.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does J31.1 sit in the tabular list?
- Diseases of the respiratory system (J00-J99), in the block Other diseases of upper respiratory tract (J30-J39).