J02.0 — Streptococcal pharyngitis
Is J02.0 billable?
Yes — J02.0 is billable for FY2027. J02.0 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. J02.0 may be submitted for encounters from October 1, 2026 through September 30, 2027.
J02.0 at a glance
| Code | J02.0 |
|---|---|
| Description | Streptococcal pharyngitis |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does J02.0 group to?
J02.0 sits in MDC Pre and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 011Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCCsurgical
- 012Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CCsurgical
- 013Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCCsurgical
How is J02.0 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to J02.0. They show the wording a clinician may have documented, which often differs from the Tabular description.
- 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
- Sore › throat › streptococcal
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative › sore throat › streptococcal
- Septic › sore › throat › streptococcal
Excludes2 — not included here
The conditions below are not part of J02.0, but a patient may have both at the same time. When documentation supports it, J02.0 and the excluded code may both be reported.
- scarlet fever (A38.-)
Inclusion terms
Alternative wording in documentation that is classified to J02.0.
- Septic pharyngitis
- Streptococcal sore throat
Excludes1 — never code together — inherited from J00-J06
The conditions below can never be reported together with J02.0 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- chronic obstructive pulmonary disease with acute lower respiratory infection (J44.0)
Excludes1 — never code together — inherited from J02
The conditions below can never be reported together with J02.0 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Use additional code — inherited from Chapter 10
Report an additional code alongside J02.0 to fully describe the condition. J02.0 is sequenced first.
Excludes2 — not included here — inherited from Chapter 10
The conditions below are not part of J02.0, but a patient may have both at the same time. When documentation supports it, J02.0 and the excluded code may both be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- smoke inhalation (T59.81-)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Excludes2 — not included here — inherited from J02
The conditions below are not part of J02.0, but a patient may have both at the same time. When documentation supports it, J02.0 and the excluded code may both be reported.
- chronic pharyngitis (J31.2)
How long has J02.0 existed?
J02.0 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.
Which codes are confused with J02.0?
ICD-10-CM declares these codes mutually exclusive with J02.0 — exactly one of each pair can be correct for a given encounter.