N40 — Benign prostatic hyperplasia
N40 is a non-billable header ICD-10-CM code for benign prostatic hyperplasia. 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.
- benign neoplasms of prostate (adenoma, benign) (fibroadenoma) (fibroma) (myoma) (D29.1)
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- malignant neoplasm of prostate (C61)
Includes
Conditions this code covers.
- adenofibromatous hypertrophy of prostate
- benign hypertrophy of the prostate
- benign prostatic hypertrophy
- BPH
- enlarged prostate
- nodular prostate
- polyp of prostate
Other codes that can never be billed with N40
These codes carry an Excludes1 note pointing at N40. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading N40 alone.
Risk adjustment
N40 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 N40
4 child codes. Green means billable.
Questions about N40
- Is N40 a billable ICD-10-CM code?
- No. N40 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does N40 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 N40?
- N40 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.