J36Peritonsillar abscess

J36 is the ICD-10-CM diagnosis code for peritonsillar abscess. It belongs to block J30-J39 (other diseases of upper respiratory tract) and chapter 10 (diseases of the respiratory system). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Don't report J36 together with the conditions in its Excludes1 note: acute tonsillitis (J03.-), chronic tonsillitis (J35.0), retropharyngeal abscess (J39.0) and tonsillitis NOS (J03.9-).

Use an additional code (B95-B97) to identify infectious agent..

As a secondary diagnosis it is a CC (complication or comorbidity), which can move an inpatient stay into the "with CC" MS-DRG of its family, unless the principal diagnosis excludes it.

In MS-DRG v44.0, it is part of the grouping logic for DRG 011 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCC, relative weight 5.6154), DRG 012 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CC, relative weight 4.381), DRG 013 (Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCC, relative weight 2.7307), DRG 152 (Otitis Media and URI with MCC, relative weight 1.1151) and DRG 153 (Otitis Media and URI without MCC, relative weight 0.7421), in Pre-MDC and MDC 03 (Diseases and Disorders of the Ear, Nose, Mouth and Throat), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as 475 (peritonsillar abscess).