ICD-10 Codes for Sinusitis
The ICD-10 codes for sinusitis depend on the specific type, location, and chronicity of the condition, with codes ranging from J01.x for acute sinusitis, J32.x for chronic sinusitis without polyps, and J33.x for chronic rhinosinusitis with nasal polyps.
Primary Code Categories
Acute Sinusitis (J01.x)
- J01.x codes are used for acute bacterial rhinosinusitis with symptoms lasting less than 4 weeks 1, 2
- These codes should be paired with documentation of purulent rhinorrhea, postnasal drainage, facial pain, or fever 1
- When coding acute sinusitis with same-day antibiotic prescription, the positive predictive value for accurate diagnosis is 92% 2
Chronic Sinusitis Without Polyps (J32.x)
- J32.x codes apply when symptoms persist for 8 weeks or longer without nasal polyps 1, 3
- This classification requires at least 2 of 4 cardinal symptoms: nasal blockage, nasal discharge, facial pain/pressure, or reduction/loss of smell 4
- Chronic sinusitis should be confirmed with objective evidence through nasal endoscopy or CT imaging when available 4
Chronic Rhinosinusitis With Nasal Polyps (J33.x)
- J33.x codes are designated for chronic rhinosinusitis with nasal polyps (CRSwNP) 3
- These patients more commonly have comorbid asthma (40.2% vs 10.3% without polyps) and allergic rhinitis 3
- CRSwNP patients typically require more extensive surgical intervention involving multiple sinus types 3
Specific Anatomic Location Codes
Pansinusitis
- Pansinusitis involves inflammation of all paranasal sinuses (maxillary, ethmoid, frontal, and sphenoid) simultaneously 5
- Coding requires documentation of mucosal thickening, air-fluid levels, or opacification in all paranasal sinuses on imaging 5
- The specific ICD-10 code structure follows the same J01.x (acute) or J32.x (chronic) pattern with anatomic modifiers 5
Unspecified Sinusitis
- Frontal, maxillary, and "unspecified" sinuses account for 88% of documented diagnoses in pediatric populations 2
- When the specific sinus location is not documented, use the "unspecified" modifier within the appropriate category 2
Clinical Documentation Requirements
Duration-Based Classification
- Acute sinusitis: symptoms less than 4 weeks 1
- Subacute sinusitis: symptoms from 4 to 8 weeks 1
- Chronic sinusitis: symptoms for 8 weeks or longer 1, 4
- Recurrent sinusitis: 3 or more episodes of acute sinusitis per year 1
Supporting Documentation
- Document specific symptoms including purulent discharge, nasal congestion, facial pain, anosmia, and cough 1, 5
- Include imaging findings when available, particularly for chronic cases requiring CT confirmation 5, 4
- Note any complications such as orbital cellulitis, intracranial extension, or cavernous sinus thrombosis, which require separate coding 5, 6
Important Coding Pitfalls
Avoid Overcoding Based on Imaging Alone
- Up to 40% of asymptomatic adults have abnormalities on sinus CT scans 5
- Always correlate imaging findings with clinical symptoms before assigning a sinusitis diagnosis code 5
Distinguish Complicated from Uncomplicated Cases
- Complicated sinusitis with extension beyond paranasal sinuses requires additional codes for specific complications 6
- Document "double worsening" pattern or severe onset when present to support acute bacterial diagnosis 6