J02.0 vs J03
J02.0 and J03 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on J03
streptococcal sore throat (J02.0)
J02.0
Streptococcal pharyngitis
Billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J00-J06
Use when the record says
- Septic pharyngitis
- Streptococcal sore throat
Indexed under
- Pharyngitis › septic (acute) (catarrhal)(gangrenous) (infective) (malignant) (membranous) (phlegmonous) (pseudomembranous) (simple) (subacute) (suppurative) (ulcerative)
- Pharyngitis › streptococcal (acute) (catarrhal)(gangrenous) (infective) (malignant) (membranous) (phlegmonous) (pseudomembranous) (simple) (subacute) (suppurative) (ulcerative)
- Disease, diseased › throat › septic
- Septic › sore › throat
- Sore › throat › septic
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027