2026 ICD-10-CM Diagnosis Code N40.3Nodular prostate with lower urinary tract symptoms

ICD-10-CM CodesN00–N99N40-N53N40

ICD-10-CM N40.3
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

N40.3 is a billable ICD-10-CM diagnosis code for nodular prostate with lower urinary tract symptoms. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 725 through 726. The code is restricted by the Medicare Code Editor to adult patients (age 15 through 124). Coders also document this condition as urinary obstruction due to nodular prostate. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Hyperplasia of prostate.

Code Identity

ICD-10-CM Code
N40.3
Billable Status
Yes — Valid for Submission
Code Describes
Nodular prostate with lower urinary tract symptoms
Short Description
Nodular prostate with lower urinary tract symptoms
Same as the full description in the CMS dataset.
Parent Code
Benign prostatic hyperplasia

Code Classification

ChapterN00–N99Diseases of the genitourinary system
SectionN40-N53Diseases of male genital organs
CategoryN40Benign prostatic hyperplasia
This CodeN40.3Nodular prostate with lower urinary tract symptoms

Code EditsBilling

Medicare Code Editor checks that affect claim validity for N40.3.

The Medicare Code Editor detects inconsistencies in adult cases by checking a patient's age and any diagnosis on the patient's record. The adult code edits apply to patients age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Urinary obstruction due to nodular prostate

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Use Additional Code

  • 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

Index to Diseases and InjuriesGuidance

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Enlargement, enlarged
      • prostate
        • with lower urinary tract symptoms (LUTS)
          • nodular
    • Enlargement, enlarged
      • prostate
        • nodular
          • with lower urinary tract symptoms (LUTS)
    • Hyperplasia, hyperplastic
      • prostate (adenofibromatous)
        • with lower urinary tract symptoms (LUTS)
          • nodular
    • Hyperplasia, hyperplastic
      • prostate (adenofibromatous)
        • nodular
          • with lower urinary tract symptoms (LUTS)
    • Nodule(s), nodular
      • prostate
        • with lower urinary tract symptoms (LUTS)

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR GEN012
Hyperplasia of prostate
Default principal diagnosis: inpatient Yes · outpatient Yes

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 N40.3 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
600.11 Nod prostate w ur obst
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About N40.3Overview

Is N40.3 (Benign prostatic hyperplasia) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report nodular prostate with lower urinary tract symptoms on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does N40.3 group to?

When nodular prostate with lower urinary tract symptoms is the principal diagnosis on an inpatient stay, it groups to MS-DRG 725, 726, with relative weights from 0.7220 to 1.1702 depending on complications. Higher weights mean higher Medicare reimbursement.

Who can N40.3 be reported for?

The Medicare Code Editor checks nodular prostate 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.

What is the ICD-9 equivalent of N40.3?

Under the General Equivalence Mappings, nodular prostate with lower urinary tract symptoms converts to ICD-9-CM 600.11 (nod prostate w ur obst). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.