ICD-10 · PDGM grouping
J00-J06 — Acute upper respiratory infections
Every ICD-10-CM code in this range and the PDGM clinical group CMS assigns to it, read from the CMS grouper crosswalk v07.2.26.
Codes in range
35
No clinical group
0
A period cannot be grouped from these.
Barred as primary
0
CMS rejects these in the primary position.
Where these codes group
34 of the 35 codes in J00-J06 group to MMTA - Other, but the range is not uniform — it spreads across 2 clinical groups. Every code here is assigned a group.
Code families in J00-J06
One page per three-character family: every code in it, whether it can lead a claim, its clinical group and comorbidity subgroup.
- J00Acute nasopharyngitis [common cold]1 code
- J01Acute sinusitis14 codes
- J02Acute pharyngitis3 codes
- J03Acute tonsillitis6 codes
- J04Acute laryngitis and tracheitis6 codes
- J05Acute obstructive laryngitis [croup] and epiglottitis3 codes
- J06Acute upper respiratory infections of multiple and unspecified sites2 codes
Every code in J00-J06
Descriptions are CMS’s own, abbreviated as CMS abbreviates them.
| Code | Description | Clinical group | Primary position |
|---|---|---|---|
| J00 | Acute nasopharyngitis [common cold] | A | Can lead a claim |
| J0100 | Acute maxillary sinusitis, unspecified | A | Can lead a claim |
| J0101 | Acute recurrent maxillary sinusitis | A | Can lead a claim |
| J0110 | Acute frontal sinusitis, unspecified | A | Can lead a claim |
| J0111 | Acute recurrent frontal sinusitis | A | Can lead a claim |
| J0120 | Acute ethmoidal sinusitis, unspecified | A | Can lead a claim |
| J0121 | Acute recurrent ethmoidal sinusitis | A | Can lead a claim |
| J0130 | Acute sphenoidal sinusitis, unspecified | A | Can lead a claim |
| J0131 | Acute recurrent sphenoidal sinusitis | A | Can lead a claim |
| J0140 | Acute pansinusitis, unspecified | A | Can lead a claim |
| J0141 | Acute recurrent pansinusitis | A | Can lead a claim |
| J0180 | Other acute sinusitis | A | Can lead a claim |
| J0181 | Other acute recurrent sinusitis | A | Can lead a claim |
| J0190 | Acute sinusitis, unspecified | A | Can lead a claim |
| J0191 | Acute recurrent sinusitis, unspecified | A | Can lead a claim |
| J020 | Streptococcal pharyngitis | A | Can lead a claim |
| J028 | Acute pharyngitis due to other specified organisms | A | Can lead a claim |
| J029 | Acute pharyngitis, unspecified | A | Can lead a claim |
| J0300 | Acute streptococcal tonsillitis, unspecified | A | Can lead a claim |
| J0301 | Acute recurrent streptococcal tonsillitis | A | Can lead a claim |
| J0380 | Acute tonsillitis due to other specified organisms | A | Can lead a claim |
| J0381 | Acute recurrent tonsillitis due to other specified organisms | A | Can lead a claim |
| J0390 | Acute tonsillitis, unspecified | A | Can lead a claim |
| J0391 | Acute recurrent tonsillitis, unspecified | A | Can lead a claim |
| J040 | Acute laryngitis | A | Can lead a claim |
| J0410 | Acute tracheitis without obstruction | A | Can lead a claim |
| J0411 | Acute tracheitis with obstruction | A | Can lead a claim |
| J042 | Acute laryngotracheitis | A | Can lead a claim |
| J0430 | Supraglottitis, unspecified, without obstruction | A | Can lead a claim |
| J0431 | Supraglottitis, unspecified, with obstruction | A | Can lead a claim |
| J050 | Acute obstructive laryngitis [croup] | A | Can lead a claim |
| J0510 | Acute epiglottitis without obstruction | A | Can lead a claim |
| J0511 | Acute epiglottitis with obstruction | A | Can lead a claim |
| J060 | Acute laryngopharyngitis | A | Can lead a claim |
| J069 | Acute upper respiratory infection, unspecified | L | Can lead a claim |
Source: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01. 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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