ICD-10 Code N40.1

Benign prostatic hyperplasia with lower urinary tract symptoms

Version 2019 Billable Code Adult Diagnoses Diagnoses For Males Only
ICD-10: N40.1
Short Description:Benign prostatic hyperplasia with lower urinary tract symp
Long Description:Benign prostatic hyperplasia with lower urinary tract symptoms

Valid for Submission

ICD-10 N40.1 is a billable code used to specify a medical diagnosis of benign prostatic hyperplasia with lower urinary tract symptoms. The code is valid for the year 2019 for the submission of HIPAA-covered transactions.

Code Classification

  • Diseases of the genitourinary system (N00–N99)
    • Diseases of male genital organs (N40-N53)
      • Benign prostatic hyperplasia (N40)

Information for Medical Professionals

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:

  • Adult diagnoses - Adult. Age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).
  • Diagnoses for males only - Diagnoses for males only.

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). The diagnosis code N40.1 is grouped in the following groups for version MS-DRG V36.0 applicable from 10/01/2018 through 09/30/2019.

  • 725 - BENIGN PROSTATIC HYPERTROPHY WITH MCC
  • 726 - BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC

Convert N40.1 to ICD-9

The following crosswalk between ICD-10 to ICD-9 is based based on the General Equivalence Mappings (GEMS) information:

  • 600.01 - BPH w urinary obs/LUTS (Approximate Flag)

Synonyms

The following clinical terms are approximate synonyms:

  • Benign prostatic hyperplasia
  • Benign prostatic hypertrophy with outflow obstruction
  • Delay when starting to pass urine
  • Desire for urination
  • Difficulty passing urine
  • Finding of bladder emptying
  • Finding of desire for urination
  • Finding of frequency of urination
  • Finding related to ability to pass urine
  • Hyperplasia of prostate
  • Incomplete emptying of bladder
  • Increased frequency of urination
  • Lower urinary tract symptoms
  • Lower urinary tract symptoms due to benign prostatic hypertrophy
  • Must strain to pass urine
  • Nocturia
  • Nocturia due to benign prostatic hypertrophy
  • Obstruction of urethra
  • Obstructive nephropathy due to prostatic hypertrophy
  • Poor stream of urine
  • Prostatic obstruction
  • Sign or symptom of the urinary system
  • Straining on urination due to benign prostatic hypertrophy
  • Strength of stream of urine - finding
  • Urgent desire to urinate
  • Urinary frequency due to benign prostatic hypertrophy
  • Urinary hesitancy due to benign prostatic hypertrophy
  • Urinary incontinence due to benign prostatic hypertrophy
  • Urinary retention due to benign prostatic hypertrophy
  • Urinary urgency due to benign prostatic hypertrophy
  • Weak urinary stream due to benign prostatic hypertrophy

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code N40.1 are found in the index:


Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references for the code N40.1 are found in the tabular index:

  • Inclusion Terms:
    • Enlarged prostate WITH LUTS

Information for Patients


Enlarged Prostate (BPH)

Also called: benign prostatic hyperplasia

The prostate is a gland in men. It helps make semen, the fluid that contains sperm. The prostate surrounds the tube that carries urine out of the body. As men age, their prostate grows bigger. If it gets too large, it can cause problems. An enlarged prostate is also called benign prostatic hyperplasia (BPH). Most men will get BPH as they get older. Symptoms often start after age 50.

BPH is not cancer, and it does not seem to increase your chance of getting prostate cancer. But the early symptoms are the same. Check with your doctor if you have

  • A frequent and urgent need to urinate, especially at night
  • Trouble starting a urine stream or making more than a dribble
  • A urine stream that is weak, slow, or stops and starts several times
  • The feeling that you still have to go, even just after urinating
  • Small amounts of blood in your urine

Severe BPH can cause serious problems over time, such as urinary tract infections, and bladder or kidney damage. If it is found early, you are less likely to develop these problems.

Tests for BPH include a digital rectal exam, blood and imaging tests, a urine flow study, and examination with a scope called a cystoscope. Treatments include watchful waiting, medicines, nonsurgical procedures, and surgery.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

  • Digital rectal exam (Medical Encyclopedia)
  • Enlarged prostate (Medical Encyclopedia)
  • Enlarged prostate - after care (Medical Encyclopedia)
  • Prostate removal (Medical Encyclopedia)
  • Prostate resection - minimally invasive (Medical Encyclopedia)
  • Urinary Retention - NIH (National Institute of Diabetes and Digestive and Kidney Diseases)

[Learn More]

ICD-10 Footnotes

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.

Index of Diseases and Injuries Definitions

  • And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
  • Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
  • Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
  • Type 1 Excludes Notes - A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
  • Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
  • Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
  • NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
  • NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
  • See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
  • See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
  • 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
  • With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.