N40-N53 — Diseases of male genital organs
ICD-10-CM codes N40-N53 cover diseases of male genital organs, within diseases of the genitourinary system. The block holds 150 codes across 14 categories, of which 121 are billable and 29 are header codes that cannot be submitted on a claim.
Risk adjustment in N40-N53
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 92 Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
What else to watch in N40-N53
- 2 codes are laterality-specific. They come in left and right pairs, and the pair is mutually exclusive on a single site: coding both without a bilateral code is a contradiction a scrubber should catch before the payer does.
- 95 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.
Categories in N40-N53
- N40Benign prostatic hyperplasia
- N41Inflammatory diseases of prostate
- N42Other and unspecified disorders of prostate
- N43Hydrocele and spermatocele
- N44Noninflammatory disorders of testis
- N45Orchitis and epididymitis
- N46Male infertility
- N47Disorders of prepuce
- N48Other disorders of penis
- N49Inflammatory disorders of male genital organs, not elsewhere classified
- N50Other and unspecified disorders of male genital organs
- N51Disorders of male genital organs in diseases classified elsewhere
- N52Male erectile dysfunction
- N53Other male sexual dysfunction