N40.0
N40.0: Benign prostatic hyperplasia without lower urinary tract symptoms
Billable / specific codeICD-10-CM
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.
Check N40.0 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Enlarged prostate without LUTS
- Enlarged prostate NOS
Excludes1 inherited from the categories above N40.0
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above N40.0
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with N40.0
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
N40.0 is named in 3 Medicare coverage policies: 3 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52986Billing and Coding: Biomarkers for Oncology
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A57427Billing and Coding: Transrectal Ultrasound
Alphabetic index entries that lead here
- 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)
Code history
Unchanged in every release from FY2024 to FY2027.