N40.0 — Benign prostatic hyperplasia without lower urinary tract symptoms
N40.0 is a billable, specific ICD-10-CM code for benign prostatic hyperplasia without lower urinary tract symptoms. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Enlarged prostate without LUTS
- Enlarged prostate NOS
Risk adjustment
N40.0 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
N40.0 is named in 3 Medicare coverage policies — 3 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52986Billing and Coding: Biomarkers for Oncology
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A57427Billing and Coding: Transrectal Ultrasound
How N40.0 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to N40.0.
- Enlargement, enlarged›prostate
- Hyperplasia, hyperplastic›prostate(adenofibromatous)
- Enlargement, enlarged›prostate›without lower urinary tract symptoms(LUTS)
- Hyperplasia, hyperplastic›prostate›without lower urinary tract symptoms(LUTS)
Related codes at this level
Codes that share N40. If N40.0 is not quite right, the correct code is usually one of these.
Questions about N40.0
- Is N40.0 a billable ICD-10-CM code?
- Yes. N40.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does N40.0 sit in the tabular list?
- Diseases of the genitourinary system (N00-N99), in the block Diseases of male genital organs (N40-N53).