ICD-10 code for staphylococcal tonsillitis

The ICD-10-CM code for staphylococcal tonsillitis is J03.80 (Acute tonsillitis due to other specified organisms). The official index lists 1 more specific code, so check the documentation for details such as type, cause, site or severity before settling on J03.80.

Within J03.8, choose J03.80 (tonsillitis due to other specified organisms) only when documentation doesn't support a more specific option: recurrent tonsillitis due to other specified organisms (J03.81).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

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.