ICD-10 Code J02.0
Acute streptococcal pharyngitis
What is the code J02.0?
J02.0 is an ICD-10-CM code used to identify acute streptococcal pharyngitis, a condition commonly known as strep throat. This code is used in medical billing and coding to accurately represent the diagnosis for insurance claims and patient records.
Detailed description of J02.0
Acute streptococcal pharyngitis (J02.0) refers to an infection of the throat caused by streptococcal bacteria, specifically Group A Streptococcus (GAS). This condition is characterized by the sudden onset of a sore throat, pain when swallowing, and often includes other systemic symptoms such as fever and swollen lymph nodes. It is a common ailment, particularly among children and adolescents, and requires prompt diagnosis and treatment to prevent complications.
Symptoms commonly associated with J02.0
- Sore throat
- Painful swallowing
- Red and swollen tonsils, sometimes with white patches or streaks of pus
- Fever
- Swollen, tender lymph nodes in the neck
- Headache
- Rash (in some cases, known as scarlet fever)
- Nausea or vomiting (more common in children)
Related and similar ICD-10 codes
- J02.9: Acute pharyngitis, unspecified
- J03.00: Acute streptococcal tonsillitis, unspecified
- J03.01: Acute recurrent streptococcal tonsillitis
- J03.90: Acute tonsillitis, unspecified
- J03.91: Acute recurrent tonsillitis, unspecified
Appropriate usage of J02.0 for billing
When billing for acute streptococcal pharyngitis using the ICD-10-CM code J02.0, it is important to ensure that the diagnosis is clearly documented in the provider's assessment portion of the note. The documentation should include clinical findings such as a positive rapid strep test or throat culture, as well as the relevant symptoms and physical examination findings. This code should be used in conjunction with appropriate procedure codes for any diagnostic tests or treatments provided.
Instructional guidelines for coding J02.0
- Document all relevant symptoms and physical examination findings that support the diagnosis.
- Use additional codes to identify any associated complications or conditions, such as scarlet fever (A38.0) or rheumatic fever (I00–I02).
- Avoid using J02.0 if the pharyngitis is not confirmed to be streptococcal in origin; use J02.9 for unspecified acute pharyngitis in such cases.
Common pitfalls in coding with J02.0
- Failing to confirm the diagnosis of streptococcal pharyngitis.
- Using J02.0 for viral or unspecified pharyngitis, which should be coded differently.
- Neglecting to use additional codes for associated conditions or complications when applicable.
Key resources for J02.0 coding
- ICD-10-CM Official Guidelines for Coding and Reporting
- American Academy of Pediatrics guidelines on the diagnosis and management of streptococcal pharyngitis
- Centers for Disease Control and Prevention (CDC) resources on streptococcal infections
- Clinical practice guidelines from the Infectious Diseases Society of America (IDSA)
Conclusion
By following the guidelines for coding ICD-10-CM code J02.0 and ensuring thorough documentation, healthcare providers can produce appropriate reimbursement and effective patient management.
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