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  6. 2024 ICD-10-CM Code Q55.4

2024 ICD-10-CM Diagnosis Code Q55.4

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

ICD-10-CM Code:
Q55.4
ICD-10 Code for:
Oth congen malform of vas def,epidid, semnl vescl & prostate
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Chronic
Code Navigator:

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)

Q55.4 is a billable diagnosis code used to specify a medical diagnosis of other congenital malformations of vas deferens, epididymis, seminal vesicles and prostate. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

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

Approximate Synonyms

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

  • Agenesis of epididymis
  • Aplasia of spermatic cord
  • Congenital absence of epididymis
  • Congenital absence of prostate
  • Congenital absence of seminal vesicle
  • 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

Clinical Classification

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.


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 References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

Code Edits

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

  • Diagnoses for males only - The Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, these edits apply to MALES only .

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 IndicatorReason 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-CM

  • ICD-9-CM Code: 752.89 - Genital organ anom NEC
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education


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 in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

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.