J35.01 Chronic tonsillitis

ICD10CM code

#### Name of the Condition
- **Chronic Tonsillitis**
- Medical Term: J35.01

#### Summary
Chronic tonsillitis is a persistent inflammation of the tonsils, which are two lymph nodes located at the back of the throat. This condition often results in recurring sore throats, tonsil stones, and other complications due to prolonged infection.

#### Causes
- Repeated bacterial or viral infections.
- Inadequate treatment of acute tonsillitis episodes.

#### Risk Factors
- Recurrent acute tonsillitis.
- Exposure to infectious agents.
- Poor oral hygiene.
- Weak immune system, possibly due to chronic conditions like diabetes.

#### Symptoms
- Frequent sore throats.
- Bad breath (halitosis).
- Swollen and tender neck glands.
- Persistent tonsil enlargement.
- Tonsilloliths (tonsil stones).
  
#### Diagnosis
- Physical examination of the throat.
- Throat swabs or cultures.
- Blood tests to check for underlying infections.
- Imaging such as ultrasound in recurrent cases to assess the extent of inflammation.

#### Treatment Options
- **Medications:** Antibiotics if bacterial infection is identified.
- **Surgical:** Tonsillectomy to remove tonsils, often recommended for severe, persistent cases. 
- **Home Care:** Gargling with salt water and staying hydrated can alleviate symptoms.

#### Prognosis and Follow-Up
- Chronic tonsillitis can significantly improve post-tonsillectomy.
- Regular follow-ups are essential to monitor recovery, especially if surgery is performed.

#### Complications
- Obstructive sleep apnea due to enlarged tonsils.
- Spread of infection to surrounding tissues (peritonsillar abscess).
- Rheumatic fever or glomerulonephritis in rare cases of untreated infection.

#### Lifestyle & Prevention
- Maintaining good oral hygiene.
- Avoiding close contact with people who have infections.
- Strengthening the immune system through a balanced diet and regular exercise.

#### When to Seek Professional Help
- Severe throat pain with difficulty swallowing.
- High fever and fatigue.
- Breathing difficulties or sleep disturbances attributed to throat swelling.

#### Additional Resources
- [American Academy of Otolaryngology](https://www.entnet.org/)
- [Mayo Clinic - Tonsillitis](https://www.mayoclinic.org/diseases-conditions/tonsillitis)

#### Tips for Medical Coders
- Ensure chronic tonsillitis is specified as "chronic" to use the ICD code J35.01.
- Confirm whether the episode is acute or chronic; acute has a different code.
- Be aware of misclassification, especially in cases involving chronic complications or associated conditions.

Medical Policies and Guidelines for Chronic tonsillitis

Related policies from health plans

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