Outpatient Facility Coding Alert

Published on Tue Aug 11, 2015 PDF

Choose one of three options for an appropriate description.

You won’t have to select from dozens of ICD-10 codes in place of ICD-9 code 034.0 (Streptococcal sore throat) when you begin using the new diagnosis system in October.

In fact, there are three ICD-10 codes to select from. One,  J02.0  (Streptococcal pharyngitis), is an approximate match to ICD 9 code 034.0 (Streptococcal sore throat). Two others give you more diagnostic options, when the provider documents additional details about the condition:

• J03.00  (Acute streptococcal tonsillitis, unspecified) and

• J03.01  (Acute recurrent streptococcal tonsillitis).

Note that with documentation support,  J03.01 could be one way to demonstrate to payers the need for a pediatric patient to receive a tonsillectomy.

Therefore, a patient who presents with strep throat will have additional coding options, such as when the infection has spread to the tonsils. Be aware that the code set reorganizes locations for some related diagnoses.

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