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ICD-10 Guide
ICD-10 CodesJ01.11

J01.11

Acute recurrent frontal sinusitis

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 J01.11 is a billable code used to indicate a diagnosis of acute recurrent frontal sinusitis.

Key Diagnostic Point:

Acute recurrent frontal sinusitis (J01.11) is characterized by the inflammation of the frontal sinuses, which are located above the eyes and are part of the paranasal sinus system. Clinically, patients may present with symptoms such as facial pain or pressure, nasal congestion, purulent nasal discharge, fever, and a reduced sense of smell. The condition is often triggered by upper respiratory infections, allergies, or anatomical variations that obstruct sinus drainage. Disease progression can lead to chronic sinusitis if recurrent episodes are not effectively managed. Diagnostic considerations include a thorough patient history, physical examination, and imaging studies such as CT scans to assess sinus involvement. Treatment typically involves decongestants, nasal corticosteroids, and in some cases, antibiotics if a bacterial infection is suspected. Understanding the anatomy of the frontal sinuses and their drainage pathways is crucial for effective management and prevention of recurrence.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires a thorough evaluation of symptoms and potential imaging.
  • Treatment complexity: May involve multiple treatment modalities including medications and possibly surgery.
  • Documentation requirements: Detailed documentation of symptoms, treatment plans, and follow-up is essential.
  • Coding specificity: Requires precise coding to differentiate from other types of sinusitis.

Audit Risk Factors

  • Common coding errors: Misclassification of acute versus chronic sinusitis.
  • Documentation gaps: Incomplete records of recurrent episodes or treatment responses.
  • Billing challenges: Potential denials if documentation does not support the recurrent nature of the condition.

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Primary Care

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Acute recurrent frontal sinusitis significantly impacts patient quality of life, leading to increased healthcare utilization due to frequent visits and treatments. It is prevalent in both adults and children, contributing to absenteeism from work and school. Effective management is crucial for reducing the burden on healthcare systems and improving population health outcomes. Quality measures may include tracking the frequency of recurrence and patient satisfaction with treatment efficacy.

ICD-9 vs ICD-10

Acute recurrent frontal sinusitis significantly impacts patient quality of life, leading to increased healthcare utilization due to frequent visits and treatments. It is prevalent in both adults and children, contributing to absenteeism from work and school. Effective management is crucial for reducing the burden on healthcare systems and improving population health outcomes. Quality measures may include tracking the frequency of recurrence and patient satisfaction with treatment efficacy.

Reimbursement & Billing Impact

Reimbursement considerations include understanding payer policies regarding sinusitis treatments and ensuring that all claims are submitted with appropriate modifiers when necessary. Best practices include regular audits of documentation and coding accuracy to minimize billing challenges.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for J00-J99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for J00-J99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by J01.11?

J01.11 covers acute recurrent frontal sinusitis, which is defined by multiple episodes of frontal sinus inflammation occurring within a year, typically characterized by similar symptoms each time.

When should J01.11 be used instead of related codes?

J01.11 should be used when the patient has a documented history of recurrent frontal sinusitis episodes, distinguishing it from J01.10, which is for a single acute episode.

What documentation supports J01.11?

Documentation should include a detailed history of recurrent symptoms, treatment responses, any imaging studies performed, and a clear treatment plan that outlines management strategies for the recurrent episodes.