Is N43 a billable ICD-10-CM code?

No. N43 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does N43 sit in the tabular list?

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

What cannot be coded together with N43?

N43 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

N43

N43 — Hydrocele and spermatocele

Non-billable headerICD-10-CM

N43 is a non-billable header ICD-10-CM code for hydrocele and spermatocele. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

congenital hydrocele (P83.5)

Includes

Conditions this code covers.

hydrocele of spermatic cord, testis or tunica vaginalis

Risk adjustment

N43 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 N43

5 child codes. Green means billable.

Questions about N43

Is N43 a billable ICD-10-CM code?: No. N43 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does N43 sit in the tabular list?: Diseases of the genitourinary system (N00-N99), in the block Diseases of male genital organs (N40-N53).
What cannot be coded together with N43?: N43 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.