J36 — Peritonsillar abscess

BillableCC

Is J36 billable?

Yes — J36 is billable for FY2027. J36 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. J36 may be submitted for encounters from October 1, 2026 through September 30, 2027.

J36 at a glance

Code	J36
Description	Peritonsillar abscess
Billable	Yes
Code set	ICD-10-CM FY2027
Valid for encounters	October 1, 2026 – September 30, 2027

Which MS-DRGs does J36 group to?

J36 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

As a secondary diagnosis, J36 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

How is J36 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to J36. They show the wording a clinician may have documented, which often differs from the Tabular description.

Peritonsillitis
Quinsy (gangrenous)
Abscess › circumtonsillar (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic)
Abscess › intratonsillar (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic)
Abscess › peritonsillar (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic)
Abscess › posttonsillar (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic)
Abscess › tonsil (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic)
Abscess › tonsillopharyngeal (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic)
Angina › phlegmonous (attack) (cardiac) (chest) (heart) (pectoris) (syndrome) (vasomotor)
Angina › tonsil (attack) (cardiac) (chest) (heart) (pectoris) (syndrome) (vasomotor)
Cellulitis › peritonsillar (diffuse) (phlegmonous) (septic) (suppurative)
Cellulitis › tonsil (diffuse) (phlegmonous) (septic) (suppurative)

Excludes1 — never code together

The conditions below can never be reported together with J36 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

acute tonsillitis (J03.-)
chronic tonsillitis (J35.0)
retropharyngeal abscess (J39.0)
tonsillitis NOS (J03.9-)

Use additional code

Report an additional code alongside J36 to fully describe the condition. J36 is sequenced first.

code (B95-B97) to identify infectious agent.

Includes

Conditions classified to J36.

abscess of tonsil
peritonsillar cellulitis
quinsy

Use additional code — inherited from Chapter 10

Report an additional code alongside J36 to fully describe the condition. J36 is sequenced first.

code, where applicable, to identify:
exposure to environmental tobacco smoke (Z77.22)
exposure to tobacco smoke in the perinatal period (P96.81)
history of tobacco dependence (Z87.891)
occupational exposure to environmental tobacco smoke (Z57.31)
tobacco dependence (F17.-)
tobacco use (Z72.0)

Excludes2 — not included here — inherited from Chapter 10

The conditions below are not part of J36, but a patient may have both at the same time. When documentation supports it, J36 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)

How long has J36 existed?

J36 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 J36?

ICD-10-CM declares these codes mutually exclusive with J36 — exactly one of each pair can be correct for a given encounter.