ICD-10-CM Code Q55.4

Other congenital malformations of vas deferens, epididymis, seminal vesicles and prostate

  1. ICD-10-CM Index
  2. Chapter: Q00-Q99
  3. Section: Q50-Q56
  4. Block: Q55
  5. Q55.4 - Oth congen malform of vas def,epidid, semnl vescl & prostate
Version 2020 Billable Code Diagnoses For Males Only POA Exempt

Valid for Submission

Q55.4 is a billable code used to specify a medical diagnosis of other congenital malformations of vas deferens, epididymis, seminal vesicles and prostate. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Q55.4 might also be used to specify conditions or terms like aplasia of spermatic cord, congenital absence of epididymis, congenital absence of prostate, congenital absence of spermatic cord, congenital absence of vas deferens, congenital anomaly of epididymis, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Q55.4 is applicable to male patients only. It is clinically and virtually impossible to use this code on a non-male patient.

ICD-10:Q55.4
Short Description:Oth congen malform of vas def,epidid, semnl vescl & prostate
Long Description:Other congenital malformations of vas deferens, epididymis, seminal vesicles and prostate

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 are applicable to the code Q55.4:

Inclusion Terms

Inclusion Terms
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.
  • Absence or aplasia of prostate
  • Absence or aplasia of spermatic cord
  • Congenital malformation of vas deferens, epididymis, seminal vesicles or prostate NOS

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 Q55.4 are found in the index:


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:

  • Aplasia of spermatic cord
  • Congenital absence of epididymis
  • Congenital absence of prostate
  • Congenital absence of spermatic cord
  • Congenital absence of vas deferens
  • Congenital anomaly of epididymis
  • Congenital anomaly of prostate
  • Congenital anomaly of spermatic cord
  • Congenital anomaly of vas deferens
  • Congenital aplasia of vas deferens
  • Congenital atresia of ejaculatory duct
  • Congenital bilateral aplasia of vas deferens
  • Congenital hypoplasia of epididymis
  • Congenital hypoplasia of vas deferens
  • Congenital malposition of epididymis
  • Congenital malposition of vas deferens
  • Craggy epididymis
  • Cyst of hydatid of Morgagni
  • Cyst of hydatid of Morgagni
  • Cyst of Wolffian duct
  • Cyst of Wolffian duct
  • Epididymis absent
  • Finding of appearance of epididymis
  • Hydatid cyst of Morgagni - male
  • Mesonephric cyst
  • Vas deferens absent
  • Wolffian duct cyst - male

Diagnostic Related Groups

The ICD-10 code Q55.4 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.

  • 729 - OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC
  • 730 - OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Present on Admission (POA)

Q55.4 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here .

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert Q55.4 to ICD-9

  • 752.89 - Genital organ anom NEC (Approximate Flag)

Code Classification

  • Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
    • Congenital malformations of genital organs (Q50-Q56)
      • Other congenital malformations of male genital organs (Q55)

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

Information for Patients


Testicular Disorders

Testicles, or testes, make male hormones and sperm. They are two egg-shaped organs inside the scrotum, the loose sac of skin behind the penis. It's easy to injure your testicles because they are not protected by bones or muscles. Men and boys should wear athletic supporters when they play sports.

You should examine your testicles monthly and seek medical attention for lumps, redness, pain or other changes. Testicles can get inflamed or infected. They can also develop cancer. Testicular cancer is rare and highly treatable. It usually happens between the ages of 15 and 40.


[Learn More]

Previous Code: Q55.3

Related Codes

Next Code: Q55.5