ICD-10 J02
Non-Billable HeaderAcute pharyngitis
About ICD-10-CM J02
ICD-10-CM code J02 represents Acute pharyngitis. This is a non-billable header code in the Respiratory System chapter (block J02). The 2026 edition of ICD-10-CM J02 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 J02. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- acute laryngopharyngitis (J06.0)
- peritonsillar abscess (J36)
- pharyngeal abscess (J39.1)
- retropharyngeal abscess (J39.0)
Type 2 Excludes
Not included here, the excluded code is not part of J02, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- chronic pharyngitis (J31.2)
Includes
- acute sore throat
Medicare LCD Coverage for J02
Local Coverage Determinations (LCDs) from CMS MACs that list J02 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 J02.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but J02 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with J02
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 J02
Other codes in section J00-J06 (Acute upper respiratory infections).
ICD-10 J02, Billing FAQ
Is ICD-10 code J02 billable? +
No, J02 is a non-billable header code. Use a more specific child code from block J02 when submitting claims.
What codes are Type 1 Excludes for J02? +
Type 1 Excludes (never code together with J02): acute laryngopharyngitis (J06.0); peritonsillar abscess (J36); pharyngeal abscess (J39.1)
What codes are Type 2 Excludes for J02? +
Type 2 Excludes (may be coded together when both conditions exist): chronic pharyngitis (J31.2)
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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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