ICD-10 J02.9
Billable / SpecificAcute pharyngitis, unspecified
About ICD-10-CM J02.9
ICD-10-CM code J02.9 represents Acute pharyngitis, unspecified. This is a billable/specific code in the Respiratory System chapter (block J02). The 2026 edition of ICD-10-CM J02.9 became effective on October 1, 2025.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under J02.9. Per CMS ICD-10-CM Tabular 2026.
- Gangrenous pharyngitis (acute)
- Infective pharyngitis (acute) NOS
- Pharyngitis (acute) NOS
- Sore throat (acute) NOS
- Suppurative pharyngitis (acute)
- Ulcerative pharyngitis (acute)
Type 1 Excludes
Pure excludes, these codes can never be coded together with J02.9. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- influenza virus with other respiratory manifestations (J09.X2, J10.1, J11.1)
Medicare LCD Coverage for J02.9
Local Coverage Determinations (LCDs) from CMS MACs that list J02.9 as a covered diagnosis.
Showing top 10 of 37 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing J02.9.
1 Cigna
3 Medicare
1 Aetna
CPT Codes Commonly Billed with J02.9
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 99202 New patient office visit — fever, headache, abdominal pain, cough, dyspnea, fatigue, dizziness, limb pain, nausea, routine exam, URI, UTI, pharyngitis, otitis, chest pain, weight loss Primary Care
- 99212 Established patient — URI, UTI, pharyngitis, otitis, dermatitis, rash, viral infection, cellulitis, conjunctivitis, sinusitis, bronchitis, ankle sprain Primary Care
- 99213 Established patient — HTN follow-up, diabetes management, hyperlipidemia, asthma, anxiety, common complaints, back pain, GERD, migraine, acne, joint pain, prediabetes, obesity, anemia, hypothyroid, fatigue Primary Care
- 99282 ED visit level 2 — same as level 1 with low complexity MDM Emergency Medicine
Convert J02.9 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| J02.9 | 462 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To J02.9
Other codes in section J00-J06 (Acute upper respiratory infections).
ICD-10 J02.9, Billing FAQ
Is ICD-10 code J02.9 billable? +
Yes, J02.9 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 J02.9? +
ICD-10 J02.9 includes: Gangrenous pharyngitis (acute); Infective pharyngitis (acute) NOS; Pharyngitis (acute) NOS, and 3 more clinical synonyms.
What codes are Type 1 Excludes for J02.9? +
Type 1 Excludes (never code together with J02.9): influenza virus with other respiratory manifestations (J09.X2, J10.1, J11.1)
What CPT codes are commonly billed with J02.9? +
Procedures frequently paired with J02.9 include: 99202, 99212, 99213, 99282.
What ICD-9 codes does J02.9 map to? +
Per CMS GEMs, J02.9 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 May 31, 2026.
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