ICD-10 J35.1
Billable / SpecificHypertrophy of tonsils
About ICD-10-CM J35.1
ICD-10-CM code J35.1 represents Hypertrophy of tonsils. This is a billable/specific code in the Respiratory System chapter (block J35). The 2026 edition of ICD-10-CM J35.1 became effective on October 1, 2025.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under J35.1. Per CMS ICD-10-CM Tabular 2026.
- Enlargement of tonsils
Type 1 Excludes
Pure excludes, these codes can never be coded together with J35.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- hypertrophy of tonsils with tonsillitis (J35.0-)
Medicare LCD Coverage for J35.1
Local Coverage Determinations (LCDs) from CMS MACs that list J35.1 as a covered diagnosis.
Showing top 10 of 35 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing J35.1.
2 Aetna
2 Medicare
CPT Codes Commonly Billed with J35.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 42820 Tonsillectomy — chronic tonsillitis, hypertrophic tonsils, sleep apnea, peritonsillar abscess, acute tonsillitis, mouth breathing, dysphagia ENT
Convert J35.1 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 |
|---|---|---|
| J35.1 | 47411 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To J35.1
Other codes in section J30-J39 (Other diseases of upper respiratory tract).
ICD-10 J35.1, Billing FAQ
Is ICD-10 code J35.1 billable? +
Yes, J35.1 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 J35.1? +
ICD-10 J35.1 includes: Enlargement of tonsils.
What codes are Type 1 Excludes for J35.1? +
Type 1 Excludes (never code together with J35.1): hypertrophy of tonsils with tonsillitis (J35.0-)
What CPT codes are commonly billed with J35.1? +
Procedures frequently paired with J35.1 include: 42820.
What ICD-9 codes does J35.1 map to? +
Per CMS GEMs, J35.1 maps to ICD-9 codes: 47411. 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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