ICD-10 J01
Non-Billable HeaderAcute sinusitis
About ICD-10-CM J01
ICD-10-CM code J01 represents Acute sinusitis. This is a non-billable header code in the Respiratory System chapter (block J01). The 2026 edition of ICD-10-CM J01 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with J01. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- sinusitis NOS (J32.9)
Type 2 Excludes
Not included here, the excluded code is not part of J01, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- chronic sinusitis (J32.0-J32.8)
Includes
- acute abscess of sinus
- acute empyema of sinus
- acute infection of sinus
- acute inflammation of sinus
- acute suppuration of sinus
Use Additional Code
When coding J01, also report these additional codes when applicable.
- code (B95-B97) to identify infectious agent.
Medicare LCD Coverage for J01
Local Coverage Determinations (LCDs) from CMS MACs that list J01 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing J01.
1 Cigna
CPT Codes Commonly Billed with J01
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
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.
Codes Adjacent To J01
Other codes in section J00-J06 (Acute upper respiratory infections).
ICD-10 J01, Billing FAQ
Is ICD-10 code J01 billable? +
No, J01 is a non-billable header code. Use a more specific child code from block J01 when submitting claims.
What codes are Type 1 Excludes for J01? +
Type 1 Excludes (never code together with J01): sinusitis NOS (J32.9)
What codes are Type 2 Excludes for J01? +
Type 2 Excludes (may be coded together when both conditions exist): chronic sinusitis (J32.0-J32.8)
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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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