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

ICD-10 J02.8

Billable / Specific

Acute pharyngitis due to other specified organisms

J02
Block
0
Synonyms
0
LCDs
1
Payer Policies
0
Linked CPTs

About ICD-10-CM J02.8

ICD-10-CM code J02.8 represents Acute pharyngitis due to other specified organisms. This is a billable/specific code in the Respiratory System chapter (block J02). The 2026 edition of ICD-10-CM J02.8 became effective on October 1, 2025.

Type 1 Excludes

Pure excludes, these codes can never be coded together with J02.8. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • acute pharyngitis due to coxsackie virus (B08.5)
  • acute pharyngitis due to gonococcus (A54.5)
  • acute pharyngitis due to herpes [simplex] virus (B00.2)
  • acute pharyngitis due to infectious mononucleosis (B27.-)
  • enteroviral vesicular pharyngitis (B08.5)

Use Additional Code

When coding J02.8, also report these additional codes when applicable.

  • code (B95-B97) to identify infectious agent

Medicare LCD Coverage for J02.8

Local Coverage Determinations (LCDs) from CMS MACs that list J02.8 as a covered diagnosis.

No Medicare LCDs reference J02.8 as covered

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 J02.8.

1 policies

1 Cigna

Nucleic Acid Pathogen Testing - (0530)
Policy ID: MM_0530

CPT Codes Commonly Billed with J02.8

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

No procedure linkages on file for J02.8

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 J02.8 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
J02.8 462 10000

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

ICD-10 J02.8, Billing FAQ

Is ICD-10 code J02.8 billable? +

Yes, J02.8 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for J02.8? +

Type 1 Excludes (never code together with J02.8): acute pharyngitis due to coxsackie virus (B08.5); acute pharyngitis due to gonococcus (A54.5); acute pharyngitis due to herpes [simplex] virus (B00.2)

What ICD-9 codes does J02.8 map to? +

Per CMS GEMs, J02.8 maps to ICD-9 codes: 462. 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 June 1, 2026.

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