ICD-10-CM Code D40.0

Neoplasm of uncertain behavior of prostate

Version 2020 Billable Code Diagnoses For Males Only Neoplasm Uncertain Behavior

Valid for Submission

D40.0 is a billable code used to specify a medical diagnosis of neoplasm of uncertain behavior of prostate. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code D40.0 might also be used to specify conditions or terms like neoplasm of uncertain behavior of prostate.

The code D40.0 is applicable to male patients only. It is clinically and virtually impossible to use this code on a non-male patient.

The following anatomical sites found in the Table of Neoplasms apply to this code given the correct histological behavior: prostate (gland) .

ICD-10:D40.0
Short Description:Neoplasm of uncertain behavior of prostate
Long Description:Neoplasm of uncertain behavior of prostate

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

  • Diagnoses for males only - Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, this code applies to MALES only .

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Neoplasm of uncertain behavior of prostate

Diagnostic Related Groups

The ICD-10 code D40.0 is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC).
applicable from 10/01/2019 through 09/30/2020.

  • 715 - OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC
  • 716 - OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC

Convert D40.0 to ICD-9

  • 236.5 - Unc behav neo prostate

Code Classification

  • Neoplasms (C00–D48)
    • Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48)
      • Neoplasm of uncertain behavior of male genital organs (D40)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Table of Neoplasms

The code D40.0 is included in the table of neoplasms by anatomical site. For each site there are six possible code numbers according to whether the neoplasm in question is malignant, benign, in situ, of uncertain behavior, or of unspecified nature. The description of the neoplasm will often indicate which of the six columns is appropriate.

Where such descriptors are not present, the remainder of the Index should be consulted where guidance is given to the appropriate column for each morphological (histological) variety listed. However, the guidance in the Index can be overridden if one of the descriptors mentioned above is present.

Neoplasm, neoplastic Malignant
Primary
Malignant
Secondary
CaInSitu Benign Uncertain
Behavior
Unspecified
Behavior
»prostate (gland)
C61C79.82D07.5D29.1D40.0D49.59

Information for Patients


Prostate Diseases

The prostate is a gland in men. It helps make semen, the fluid that contains sperm. The prostate surrounds the tube that carries urine away from the bladder and out of the body. A young man's prostate is about the size of a walnut. It slowly grows larger with age. If it gets too large, it can cause problems. This is very common after age 50. The older men get, the more likely they are to have prostate trouble.

Some common problems are

  • Prostatitis - inflammation, usually caused by bacteria
  • Enlarged prostate (BPH), or benign prostatic hyperplasia - a common problem in older men which may cause dribbling after urination or a need to go often, especially at night
  • Prostate cancer - a common cancer that responds best to treatment when detected early

NIH: National Institute of Diabetes and Digestive and Kidney Diseases


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