Is N42.8 a billable ICD-10-CM code?

No. N42.8 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does N42.8 sit in the tabular list?

Diseases of the genitourinary system (N00-N99), in the block Diseases of male genital organs (N40-N53).

N42.8

N42.8 — Other specified disorders of prostate

Non-billable headerICD-10-CM

N42.8 is a non-billable header ICD-10-CM code for other specified disorders of prostate. It cannot be billed on its own: choose one of the more specific child codes below.

Risk adjustment

N42.8 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.

Code to one of these instead N42.8

4 child codes. Green means billable.

N42.81Prostatodynia syndrome
N42.82Prostatosis syndrome
N42.83Cyst of prostate
N42.89Other specified disorders of prostate

Related codes at this level

Codes that share N42. If N42.8 is not quite right, the correct code is usually one of these.

N42.0Calculus of prostate
N42.1Congestion and hemorrhage of prostate
N42.3Dysplasia of prostate
N42.9Disorder of prostate, unspecified

Questions about N42.8

Is N42.8 a billable ICD-10-CM code?: No. N42.8 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does N42.8 sit in the tabular list?: Diseases of the genitourinary system (N00-N99), in the block Diseases of male genital organs (N40-N53).