ICD-10 J39.0
Billable / Specific CCRetropharyngeal and parapharyngeal abscess
About ICD-10-CM J39.0
ICD-10-CM code J39.0 represents Retropharyngeal and parapharyngeal abscess. This is a billable/specific code in the Respiratory System chapter (block J39). The 2026 edition of ICD-10-CM J39.0 became effective on October 1, 2025.
Coding Tips for J39.0
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
J39.0 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under J39.0. Per CMS ICD-10-CM Tabular 2026.
- Peripharyngeal abscess
Type 1 Excludes
Pure excludes, these codes can never be coded together with J39.0. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- peritonsillar abscess (J36)
Inpatient DRG Impact, CC
codes Retropharyngeal and parapharyngeal abscess. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for J39.0
Local Coverage Determinations (LCDs) from CMS MACs that list J39.0 as a covered diagnosis.
Showing top 10 of 83 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing J39.0.
3 Medicare
1 Aetna
CPT Codes Commonly Billed with J39.0
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.
Convert J39.0 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 |
|---|---|---|
| J39.0 | 47822 | 10000 |
| J39.0 | 47824 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To J39.0
Other codes in section J30-J39 (Other diseases of upper respiratory tract).
ICD-10 J39.0, Billing FAQ
Is ICD-10 code J39.0 billable? +
Yes, J39.0 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 J39.0? +
ICD-10 J39.0 includes: Peripharyngeal abscess.
What codes are Type 1 Excludes for J39.0? +
Type 1 Excludes (never code together with J39.0): peritonsillar abscess (J36)
Is J39.0 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What ICD-9 codes does J39.0 map to? +
Per CMS GEMs, J39.0 maps to ICD-9 codes: 47822, 47824. 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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