Skip to main content

J36 vs J39.0

J36 (Peritonsillar abscess) compared with J39.0 (Retropharyngeal and parapharyngeal abscess), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. J36 carries an Excludes1 note covering J39.0: “retropharyngeal abscess (J39.0)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

No — do not report together. J39.0 carries an Excludes1 note covering J36: “peritonsillar abscess (J36)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

J36Peritonsillar abscessJ39.0Retropharyngeal and parapharyngeal abscess
Billing statusBillableBillable
ClassificationJ00-J99 — Diseases of the Respiratory System (J00-J99)J00-J99 — Diseases of the Respiratory System (J00-J99)
DefinitionPeritonsillar abscess is a billable ICD-10-CM diagnosis code (J36).Retropharyngeal and parapharyngeal abscess is a billable ICD-10-CM diagnosis code (J39.0).
Includes
abscess of tonsil
peritonsillar cellulitis
quinsy
Peripharyngeal abscess
Use additional code
code (B95-B97) to identify infectious agent.

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources