ICD-10 · PDGM grouping
J03 Acute tonsillitis
All 6 codes in the J03 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
6
Can lead a claim
6
Cannot lead a claim
0
What CMS assigns to J03
All 6 codes group to MMTA - Other. None of the 6 is assigned a comorbidity subgroup. Every code can lead a claim.
Every code in J03
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| J03.0 Streptococcal tonsillitis | ||||
| J03.00 | Acute streptococcal tonsillitis, unspecified | Can lead a claim | A | None |
| J03.01 | Acute recurrent streptococcal tonsillitis | Can lead a claim | A | None |
| J03.8 Acute tonsillitis due to other specified organisms | ||||
| J03.80 | Acute tonsillitis due to other specified organisms | Can lead a claim | A | None |
| J03.81 | Acute recurrent tonsillitis due to other specified organisms | Can lead a claim | A | None |
| J03.9 Acute tonsillitis, unspecified | ||||
| J03.90 | Acute tonsillitis, unspecified | Can lead a claim | A | None |
| J03.91 | Acute recurrent tonsillitis, unspecified | Can lead a claim | A | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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