Code: J35.3
Description: Hypertrophy of tonsils with hypertrophy of adenoids
Context: This code applies when both tonsils and adenoids are enlarged, commonly causing airway obstruction or sleep-disordered breathing.

Guidelines for Proper Use

• Both tonsils and adenoids enlarged: Use when documentation confirms hypertrophy of both.
• Common in pediatric patients: Often leads to snoring, mouth breathing, or obstructive sleep apnea.
• Supports surgical indication: Used for tonsillectomy and adenoidectomy justification.
• Exclude infections: Do not use during acute tonsillitis or adenoiditis; those have separate codes.
• Confirm with physical exam: Diagnosis is based on oropharyngeal examination or imaging.

Common Misuses of J35.3

• Using for acute infection: Should not replace acute tonsillitis or adenoiditis codes.
• Coding for tonsils only: Use J35.1 if adenoids are not involved.
• Without exam confirmation: Avoid using if hypertrophy is not clinically documented.
• Overuse in adults: More common and relevant in children or adolescents.

Notes / Documentation Tips

• Document symptoms: Snoring, sleep apnea, chronic mouth breathing, or dysphagia.
• Include findings: Describe tonsil size and adenoid enlargement observed during exam.
• Pre-op justification: Supports surgical necessity for T&A procedures.
• List complications: Note if airway obstruction or recurrent infections occur.
• Follow-up: Include post-surgical improvement if applicable.