ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesJ01.2

J01.2

Acute ethmoidal sinusitis

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

Code Description

ICD-10 J01.2 is a used to indicate a diagnosis of acute ethmoidal sinusitis.

Key Diagnostic Point:

Acute ethmoidal sinusitis is an inflammation of the ethmoid sinuses, which are located between the nose and the eyes. Clinically, patients may present with nasal congestion, facial pain or pressure, purulent nasal discharge, and reduced sense of smell. Symptoms can also include fever, headache, and cough, which may worsen at night. The condition often arises following a viral upper respiratory infection, leading to blockage of the sinus drainage pathways. The ethmoid sinuses are part of the paranasal sinus system, and their inflammation can lead to complications if not treated, including the potential for chronic sinusitis or orbital cellulitis. Diagnosis typically involves a thorough clinical evaluation, including a physical examination and possibly imaging studies such as CT scans to assess sinus involvement. Treatment usually includes decongestants, nasal corticosteroids, and in some cases, antibiotics if a bacterial infection is suspected. Understanding the anatomy and pathophysiology of the ethmoidal sinuses is crucial for effective management and prevention of recurrence.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other types of sinusitis and upper respiratory infections.
  • Treatment complexity: May involve both medical management and surgical intervention in severe cases.
  • Documentation requirements: Requires detailed clinical notes to support diagnosis and treatment.
  • Coding specificity: Specific to acute ethmoidal sinusitis, necessitating accurate coding to avoid misrepresentation.

Audit Risk Factors

  • Common coding errors: Misclassification with other sinusitis codes.
  • Documentation gaps: Incomplete clinical notes that do not support the diagnosis.
  • Billing challenges: Potential denials if the medical necessity is not clearly established.

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 ethmoidal sinusitis significantly impacts patient quality of life and can lead to increased healthcare utilization, including emergency visits and potential surgical interventions. Understanding its epidemiology is crucial, as it affects a substantial portion of the population, particularly during cold and flu seasons. Effective management and coding of this condition can improve health outcomes and reduce the burden on healthcare systems.

ICD-9 vs ICD-10

Acute ethmoidal sinusitis significantly impacts patient quality of life and can lead to increased healthcare utilization, including emergency visits and potential surgical interventions. Understanding its epidemiology is crucial, as it affects a substantial portion of the population, particularly during cold and flu seasons. Effective management and coding of this condition can improve health outcomes and reduce the burden on healthcare systems.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity for medical management or surgical intervention, depending on the severity of the condition. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that all relevant clinical information is included in the patient's record to support the billing process and reduce the risk of audits. Best practices include using specific codes that accurately reflect the diagnosis and maintaining clear communication with payers regarding the treatment provided.

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 J01.2?

J01.2 specifically covers acute ethmoidal sinusitis, which may be caused by viral or bacterial infections, and can present with symptoms such as nasal obstruction, facial pain, and purulent nasal discharge.

When should J01.2 be used instead of related codes?

J01.2 should be used when the clinical presentation specifically indicates acute ethmoidal sinusitis, as opposed to other types of sinusitis, which have their own distinct codes.

What documentation supports J01.2?

Documentation should include clinical findings such as symptomatology, physical examination results, imaging studies if performed, and treatment plans that justify the diagnosis of acute ethmoidal sinusitis.