Is N43.4 a billable ICD-10-CM code?

No. N43.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does N43.4 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 N43.4?

N43.4 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above N43.4 (N43) and apply to it just the same.

N43.4

N43.4 — Spermatocele of epididymis

Non-billable headerICD-10-CM

N43.4 is a non-billable header ICD-10-CM code for spermatocele of epididymis. It cannot be billed on its own: choose one of the more specific child codes below.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Spermatic cyst

Excludes1 inherited from the categories above N43.4

These are not written on N43.4, but they bind it: a note on a category applies to every code beneath it. Billing N43.4 with anything listed here is a denial.

Written on N43 — Hydrocele and spermatocele

congenital hydrocele (P83.5)

Risk adjustment

N43.4 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 history

N43.4 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead N43.4

3 child codes. Green means billable.

Related codes at this level

Codes that share N43. If N43.4 is not quite right, the correct code is usually one of these.

Questions about N43.4

Is N43.4 a billable ICD-10-CM code?: No. N43.4 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does N43.4 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 N43.4?: N43.4 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above N43.4 (N43) and apply to it just the same.