ICD-10 Codes to Document Pharyngitis – An Overview

by | Last updated Jul 5, 2023 | Published on Mar 8, 2018 | Medical Coding

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Pharyngitis is the inflammation of the pharynx which is located at the back of the throat. Often referred to as sore throat, this condition causes discomfort, pain or scratchiness in the throat leading to difficulty in swallowing. Pharyngitis can involve some or all parts of the throat such as – the back part of the tongue, the soft palate (roof of the mouth) and the tonsils (fleshy tissue that are part of the throat’s immune defenses). This condition, in most cases is present because of another illness such as cold, flu or mononucleosis. According to the American Osteopathic Association (AOA), pharyngitis-induced sore throat is one of the most frequent reasons for physician visits. More cases of this condition occur during the colder months of the year. One of the most common causes of sore throat is infection with bacteria or viruses such as the common cold, influenza, or mononucleosis. Quick diagnosis of the root causes and symptoms of sore throat is essential for healthcare providers to give proper treatment for the same. Accurate documentation is crucial to ensure appropriate care, and medical coding outsourcing is an ideal option for physicians to streamline their documentation process.

What Are the Symptoms of Pharyngitis?

The main symptom of pharyngitis is a sore throat and pain with swallowing. The other signs and symptoms may vary depending on the type and severity of the underlying condition and may include –

  • Sneezing
  • Headache
  • Cough
  • Fever
  • Joint pain and muscle aches
  • Skin rashes
  • Swollen lymph glands in the neck
  • Severe fatigue
  • General malaise
  • Loss of appetite

In addition, frequent exposure to colds and flus can potentially increase the risk for this throat condition. Allergies, smoking and exposure to second-hand smoke may also raise your risk.

Diagnosing and Documenting Pharyngitis

For those experiencing symptoms of pharyngitis, physicians will generally check for any white or grey patches, swelling and redness. They will also feel the sides of the neck to check for a swollen lymph. In some cases, a complete blood count (CBC) test may be done to determine if you have another type of infection. In addition, a throat swab test will be recommended by the physician wherein the doctor rubs a sterile swab over the back of the throat to get a sample of secretions. The sample will be further checked to identify the presence of streptococcal bacteria, the cause of strep throat. Typically, a sore throat (caused by a viral infection) may last for five to seven days and doesn’t require any medical treatment. However, to ease pain and fever, many people turn to acetaminophen (Tylenol, others) or other mild pain relievers. On the other hand, if the sore throat is caused by a bacterial infection, physicians will prescribe antibiotics.

Treatment for pharyngitis mainly focuses on reducing symptoms and understanding the risk factors so that people can live their life as normal as possible. Accurately diagnosing the condition and submitting proper clinical documentation helps in promoting error-free billing practices. Relying on the services of a professional medical coding company can ensure this. ICD-10 codes for diagnosing this disorder include –

  • J02 – Acute pharyngitis
  • J02.0 – Streptococcal pharyngitis
  • J02.8 – Acute pharyngitis due to other specified organisms
  • J02.9 – Acute pharyngitis, unspecified
  • J31.1 – Chronic nasopharyngitis
  • J31.2 – Chronic pharyngitis

Regardless of the causes of sore throat, there are several home-care strategies that can help ease your symptoms. Maintaining proper hygiene can prevent most cases of this disease. Preventing bacterial infections can help reduce the spread of infections. Giving adequate voice rest and avoiding exposure to secondhand smoke can help prevent spreading this condition.

Julie Clements

Julie Clements, OSI’s Vice President of Operations, brings a diverse background in healthcare staffing and a robust six-year tenure as the Director of Sales and Marketing at a prestigious 4-star resort.

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