ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 J00

Billable / Specific

Acute nasopharyngitis [common cold]

J00
Block
6
Synonyms
37
LCDs
3
Payer Policies
0
Linked CPTs

About ICD-10-CM J00

ICD-10-CM code J00 represents Acute nasopharyngitis [common cold]. This is a billable/specific code in the Respiratory System chapter (block J00). The 2026 edition of ICD-10-CM J00 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under J00. Per CMS ICD-10-CM Tabular 2026.

  • Acute rhinitis
  • Coryza (acute)
  • Infective nasopharyngitis NOS
  • Infective rhinitis
  • Nasal catarrh, acute
  • Nasopharyngitis NOS

Type 1 Excludes

Pure excludes, these codes can never be coded together with J00. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • acute pharyngitis (J02.-)
  • acute sore throat NOS (J02.9)
  • influenza virus with other respiratory manifestations (J09.X2, J10.1, J11.1)
  • pharyngitis NOS (J02.9)
  • rhinitis NOS (J31.0)
  • sore throat NOS (J02.9)

Type 2 Excludes

Not included here, the excluded code is not part of J00, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • allergic rhinitis (J30.1-J30.9)
  • chronic pharyngitis (J31.2)
  • chronic rhinitis (J31.0)
  • chronic sore throat (J31.2)
  • nasopharyngitis, chronic (J31.1)
  • vasomotor rhinitis (J30.0)

Medicare LCD Coverage for J00

Local Coverage Determinations (LCDs) from CMS MACs that list J00 as a covered diagnosis.

37 LCDs

Showing top 10 of 37 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Respiratory Pathogen Panel Testing
Article ID: 58577, Effective: 2026-01-01 00:00:00, 193 covered, 0 non-covered
CPT 0202U →
CMS LCD: Billing and Coding: Respiratory Pathogen Panel Testing
Article ID: 58577, Effective: 2026-01-01 00:00:00, 193 covered, 0 non-covered
CPT 0225U →
CMS LCD: Billing and Coding: Respiratory Pathogen Panel Testing
Article ID: 58577, Effective: 2026-01-01 00:00:00, 193 covered, 0 non-covered
CPT 0223U →
CMS LCD: Billing and Coding: Respiratory Pathogen Panel Testing
Article ID: 58577, Effective: 2026-01-01 00:00:00, 193 covered, 0 non-covered
CPT 87913 →
CMS LCD: Billing and Coding: Respiratory Pathogen Panel Testing
Article ID: 58577, Effective: 2026-01-01 00:00:00, 193 covered, 0 non-covered
CPT 87812 →
CMS LCD: Billing and Coding: Respiratory Pathogen Panel Testing
Article ID: 58577, Effective: 2026-01-01 00:00:00, 193 covered, 0 non-covered
CPT 87633 →
CMS LCD: Billing and Coding: Respiratory Pathogen Panel Testing
Article ID: 58577, Effective: 2026-01-01 00:00:00, 193 covered, 0 non-covered
CPT 87428 →
CMS LCD: Billing and Coding: Respiratory Pathogen Panel Testing
Article ID: 58577, Effective: 2026-01-01 00:00:00, 193 covered, 0 non-covered
CPT 0115U →
CMS LCD: Billing and Coding: Respiratory Pathogen Panel Testing
Article ID: 58577, Effective: 2026-01-01 00:00:00, 193 covered, 0 non-covered
CPT 87637 →
CMS LCD: Billing and Coding: Respiratory Pathogen Panel Testing
Article ID: 58577, Effective: 2026-01-01 00:00:00, 193 covered, 0 non-covered
CPT 87631 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing J00.

3 policies

3 Medicare

Billing and Coding: Respiratory Pathogen Panel Testing
Policy ID: ART-58575
Billing and Coding: Respiratory Pathogen Panel Testing
Policy ID: ART-58577
Billing and Coding: Respiratory Pathogen Panel Testing
Policy ID: ART-58741

CPT Codes Commonly Billed with J00

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for J00

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert J00 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
J00 460 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 J00, Billing FAQ

Is ICD-10 code J00 billable? +

Yes, J00 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to J00? +

ICD-10 J00 includes: Acute rhinitis; Coryza (acute); Infective nasopharyngitis NOS, and 3 more clinical synonyms.

What codes are Type 1 Excludes for J00? +

Type 1 Excludes (never code together with J00): acute pharyngitis (J02.-); acute sore throat NOS (J02.9); influenza virus with other respiratory manifestations (J09.X2, J10.1, J11.1)

What codes are Type 2 Excludes for J00? +

Type 2 Excludes (may be coded together when both conditions exist): allergic rhinitis (J30.1-J30.9); chronic pharyngitis (J31.2); chronic rhinitis (J31.0)

What ICD-9 codes does J00 map to? +

Per CMS GEMs, J00 maps to ICD-9 codes: 460. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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