Find information on Streptococcal Pharyngitis diagnosis, including clinical documentation, ICD-10 codes (J02.0), medical coding, rapid strep test, throat culture, signs and symptoms, treatment, and antibiotic prescribing guidelines. Learn about accurate diagnosis coding for strep throat and best practices for healthcare professionals. This resource provides guidance on documenting patient encounters with strep throat and ensuring proper coding for reimbursement and epidemiological tracking.
Also known as
Streptococcal pharyngitis
Strep throat infection caused by Streptococcus.
Acute pharyngitis, other specified
Acute sore throat due to a specified organism, not strep.
Acute pharyngitis, unspecified
Acute sore throat without a specified cause.
Acute upper respiratory infections
Infections affecting the nose, throat, and other upper airways.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the pharyngitis confirmed streptococcal?
Yes
Is it Group A Strep?
No
Do NOT code as streptococcal pharyngitis. Consider other diagnoses.
When to use each related code
| Description |
|---|
| Strep Throat |
| Viral Pharyngitis |
| Infectious Mononucleosis |
Incorrect coding of strep tests (e.g., rapid antigen, culture) can lead to claim denials and inaccurate reporting. Ensure proper CPT codes are used.
Lack of documented symptoms or positive strep test results may raise audit flags. CDI specialists should query physicians for supporting documentation.
Coding pharyngitis as strep throat without confirmation can lead to overcoding and compliance issues. Accurate diagnosis documentation is crucial.
Subjective: Patient presents with complaints of sore throat, odynophagia, and difficulty swallowing. Onset reported as two days ago. Patient also reports fever, chills, headache, and malaise. Denies cough or rhinorrhea. Reports potential exposure to strep throat at school. Past medical history unremarkable for recurrent strep throat or rheumatic fever. Allergies: No known drug allergies. Medications: None. Social history: Student. Non-smoker. Objective: Vital signs: Temperature 101.2 F, pulse 90 bpm, respirations 18 breaths per minute, blood pressure 12080 mmHg. Physical exam reveals erythematous oropharynx with tonsillar exudates. Tender anterior cervical lymphadenopathy noted. Lungs clear to auscultation. Cardiovascular exam normal. Rapid strep test positive. Assessment: Streptococcal pharyngitis (Strep throat) confirmed by positive rapid strep test. Differential diagnoses considered included viral pharyngitis, infectious mononucleosis, and peritonsillar abscess. Given the positive rapid strep test and clinical presentation, the diagnosis of strep throat is most likely. Plan: Treatment plan includes Amoxicillin 500mg three times daily for 10 days. Patient education provided on the importance of completing the full course of antibiotics, proper hand hygiene, and avoiding close contact with others to prevent transmission. Follow-up recommended in one week if symptoms do not improve or worsen. Discussed potential complications such as rheumatic fever and glomerulonephritis. Patient advised to return if fever persists beyond 72 hours, difficulty breathing or swallowing develops, or any signs of allergic reaction occur. ICD-10 code J02.0, Strep throat.