Tonsillar Hypertrophy ICD-10-CM Codes

What are Tonsillar Hypertrophy ICD-10-CM Codes?

Tonsillar hypertrophy, or enlargement of the tonsils, is a condition often linked to upper respiratory tract issues, chronic diseases, or recurring infections. It may cause symptoms like difficulty swallowing, snoring, or sore throat, and is prevalent in pediatric cases, but also occurs in adults. The ICD-10-CM system provides specific diagnosis codes to classify these conditions accurately, supporting documentation, medical billing, and treatment plans.

Below are commonly used ICD-10-CM codes for tonsillar hypertrophy and associated conditions:

• J35.1 – Hypertrophy of tonsils with hypertrophy of adenoids: Used when both tonsils and adenoids are enlarged, often due to chronic conditions of the respiratory system.
• J35.2 – Hypertrophy of tonsils with sore throat: Applied when acute tonsillitis or chronic tonsillitis presents with a sore throat.
• J35.3 – Hypertrophy of tonsils with hypertrophy of adenoids with sore throat: For cases involving multiple symptoms, including tonsillar tag ulcer and cicatrix of tonsil.
• J35.8 – Other chronic diseases of tonsils and adenoids: Captures underlying conditions not specifically coded, such as tonsil cicatrix, adenoid vegetations, and amygdalolith (tonsil stones).
• J35.9 – Chronic disease of tonsils and adenoids, unspecified: Used when the chronic condition is undefined but still involves tonsils and adenoids, unspecified.
• R06.6 – Hiccough: Though less common, it can be linked to vocal cord irritation due to nearby enlarged tonsils.
• R06.83 – Snoring: Caused by adenoid hypertrophy or tonsil hypertrophy impacting airflow.
• R06.89 – Other abnormalities of breathing: Includes any irregular breathing patterns related to chronic diseases of the tonsils.
• R09.82 – Postnasal drip: Often seen in patients with nose and nasal sinus complications resulting from tonsillar hypertrophy.

Which Tonsillar Hypertrophy ICD-10-CM Codes are billable

Yes, the ICD-10 codes listed above related to tonsillar hypertrophy are all billable for clinical documentation and insurance claims.

Clinical information

• Tonsillar hypertrophy refers to the enlargement of the tonsils and lymphoid tissues at the back of the throat.
• It can occur in children and adults and may result from various causes, including infections (e.g., recurrent tonsillitis), allergies, or chronic irritation.
• Assessment involves a physical examination to evaluate the tonsils' size, condition, and associated symptoms.
• Symptoms of tonsillar hypertrophy can include snoring, difficulty swallowing, a sensation of a lump in the throat, or sleep apnea in severe cases.
• Management options depend on the underlying cause and the severity of symptoms.
• Antibiotics may be prescribed for tonsillitis or recurrent infections, while allergy management can help reduce inflammation.
• In some cases, surgical removal of the tonsils (tonsillectomy) may be recommended, particularly for severe or recurrent issues.
• Close monitoring and follow-up are crucial for assessing tonsil size and symptom progression, particularly in children.
• Patient education should include information on tonsillectomy's potential benefits and risks and post-operative care instructions when applicable.
• Referral to an ear, nose, and throat (ENT) specialist may be necessary for a comprehensive evaluation and management plan, especially when considering surgical intervention.

Synonyms include

• Enlarged tonsils
• Tonsil hypertrophy
• Tonsil enlargement
• Adenotonsillar hypertrophy
• Obstructive tonsillar hypertrophy