Is N43.40 a billable ICD-10-CM code?

Yes. N43.40 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does N43.40 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 N43.40?

N43.40 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 N43.40 (N43) and apply to it just the same.

N43.40

N43.40 — Spermatocele of epididymis, unspecified

Billable / specific codeICD-10-CM

N43.40 is a billable, specific ICD-10-CM code for spermatocele of epididymis, unspecified. It is valid for submission on a claim.

Excludes1 inherited from the categories above N43.40

These are not written on N43.40, but they bind it: a note on a category applies to every code beneath it. Billing N43.40 with anything listed here is a denial.

Written on N43 — Hydrocele and spermatocele

congenital hydrocele (P83.5)

Risk adjustment

N43.40 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

N43.40 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57591Billing and Coding: Non-Invasive Abdominal / Visceral Vascular Studies

How N43.40 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 N43.40.

Spermatocele

Code history

N43.40 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share N43.4. If N43.40 is not quite right, the correct code is usually one of these.

Questions about N43.40

Is N43.40 a billable ICD-10-CM code?: Yes. N43.40 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does N43.40 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 N43.40?: N43.40 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 N43.40 (N43) and apply to it just the same.