2027 ICD-10-CM Diagnosis Code N40.1Benign prostatic hyperplasia with lower urinary tract symptoms
ICD-10-CM Codes›N00–N99›N40-N53›N40
- Billable — Valid for Submission
- Chronic Condition
N40.1 is a billable ICD-10-CM diagnosis code for benign prostatic hyperplasia with lower urinary tract symptoms. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 725 through 726. The code is restricted by the Medicare Code Editor to adult patients (age 15 through 124). In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Hyperplasia of prostate.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for N40.1.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Benign prostatic hyperplasia
- Benign prostatic hyperplasia with outflow obstruction
- Delay when starting to pass urine
- Desire for urination
- Difficulty passing urine
- Finding of desire for urination
- Finding of frequency of urination
- Finding of urinary bladder control
- Finding of urinary bladder emptying
- Finding related to ability to pass urine
- Hyperplasia of prostate
- Incomplete emptying of urinary bladder
- Incomplete emptying of urinary bladder due to benign prostatic hypertrophy
- 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
- 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 urgency due to benign prostatic hypertrophy
- Weak urinary stream due to benign prostatic hypertrophy
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to N40.1: its own notes plus those printed at N40 and Chapter 14. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- adenofibromatous hypertrophy of prostate
- benign hypertrophy of the prostate
- benign prostatic hypertrophy
- BPH
- enlarged prostate
- nodular prostate
- polyp of prostate
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Enlarged prostate with LUTS
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code for associated symptoms, when specified:
- incomplete bladder emptying (R39.14)
- nocturia (R35.1)
- straining on urination (R39.16)
- urinary frequency (R35.0)
- urinary hesitancy (R39.11)
- urinary incontinence (N39.4-)
- urinary obstruction (N13.8)
- urinary retention (R33.8)
- urinary urgency (R39.15)
- weak urinary stream (R39.12)
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name N40.1, its category, or a range that includes it.
Excludes1 3
These codes carry an Excludes1 note naming N40.1: they are not reported together with it, unless the two conditions are unrelated.
- D29.1 Benign neoplasm of prostateenlarged prostate (N40.-) names N40.-, which includes this code
- N42.1 Congestion and hemorrhage of prostateenlarged prostate (N40.-) names N40.-, which includes this code
- N42.1 Congestion and hemorrhage of prostatehyperplasia of prostate (N40.-) names N40.-, which includes this code
Code First 4
These codes say to code first a condition named in the note, and N40.1 is one of the conditions named.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Enlargement, enlarged See Also: Hypertrophy;
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Benign Prostatic Hyperplasia
a non-cancerous nodular enlargement of the prostate gland. it is characterized by the presence of epithelial cell nodules, and stromal nodules containing fibrous and smooth muscle elements. it is the most common urologic disorder in men, causing blockage of urine flow.
Patient EducationClinical
Enlarged Prostate (BPH)
The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.
The full article covers:
- What is the prostate?
- What is an enlarged prostate (BPH)?
- What causes an enlarged prostate (BPH)?
- Who is more likely to develop BPH?
- What are the symptoms of BPH?
- What other problems can BPH cause?
- How is BPH diagnosed?
- What are the treatments for BPH?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert N40.1 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About N40.1Overview
What is the ICD-10 code for benign prostatic hyperplasia with lower urinary tract symptoms?
The ICD-10-CM code for benign prostatic hyperplasia with lower urinary tract symptoms is N40.1 (sometimes written as N401). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is N40.1 (Benign prostatic hyperplasia) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report benign prostatic hyperplasia with lower urinary tract symptoms on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does N40.1 group to?
When benign prostatic hyperplasia with lower urinary tract symptoms is the principal diagnosis on an inpatient stay, it groups to MS-DRG 725, 726, with relative weights from 0.7249 to 1.1573 depending on complications. Higher weights mean higher Medicare reimbursement.
Who can N40.1 be reported for?
The Medicare Code Editor checks benign prostatic hyperplasia with lower urinary tract symptoms against patient demographics: this code is intended for adult patients (age 15 through 124). Claims outside these limits are flagged as inconsistent.
Can N40.1 be reported with D29.1?
Not as a rule. The Excludes1 note at N40, which applies to N40.1, lists "benign neoplasms of prostate (adenoma, benign) (fibroadenoma) (fibroma) (myoma) (D29.1)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
