ICD-10-CM Code Z87.438

Personal history of other diseases of male genital organs

Version 2020 Billable Code Diagnoses For Males Only Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z87.438 is a billable code used to specify a medical diagnosis of personal history of other diseases of male genital organs. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z87.438 might also be used to specify conditions or terms like h/o: dyspareunia, h/o: genital prolapse, h/o: infertility - male, h/o: male genital disorder, h/o: prostatism, h/o: sexual function problem, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z87.438 is applicable to male patients only. It is clinically and virtually impossible to use this code on a non-male patient.

ICD-10:Z87.438
Short Description:Personal history of other diseases of male genital organs
Long Description:Personal history of other diseases of male genital organs

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 Z87.438 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 .
  • Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual’s health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Synonyms

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

  • H/O: dyspareunia
  • H/O: genital prolapse
  • H/O: infertility - male
  • H/O: male genital disorder
  • H/O: prostatism
  • H/O: sexual function problem
  • H/O: sexual function problem
  • H/O:male sex function problem
  • History of hypospermatogenesis
  • History of male erectile disorder
  • History of maturation arrest of spermatogenesis
  • History of prostatic cyst
  • History of prostatitis
  • History of semen abnormality
  • History of sexually transmitted disease
  • History of testicular disorder

Present on Admission (POA)

Z87.438 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 Z87.438 to ICD-9

  • V13.89 - Hx diseases NEC (Approximate Flag)

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)
      • Personal history of other diseases and conditions (Z87)

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


Penis Disorders

Problems with the penis can cause pain and affect a man's sexual function and fertility. Penis disorders include

  • Erectile dysfunction - inability to get or keep an erection
  • Priapism - a painful erection that does not go away
  • Peyronie's disease - bending of the penis during an erection due to a hard lump called a plaque
  • Balanitis - inflammation of the skin covering the head of the penis, most often in men and boys who have not been circumcised
  • Penile cancer - a rare form of cancer, highly curable when caught early

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Prostate Diseases

The prostate is a gland in men. It helps make semen, the fluid that contains sperm. The prostate surrounds the tube that carries urine away from the bladder and out of the body. A young man's prostate is about the size of a walnut. It slowly grows larger with age. If it gets too large, it can cause problems. This is very common after age 50. The older men get, the more likely they are to have prostate trouble.

Some common problems are

  • Prostatitis - inflammation, usually caused by bacteria
  • Enlarged prostate (BPH), or benign prostatic hyperplasia - a common problem in older men which may cause dribbling after urination or a need to go often, especially at night
  • Prostate cancer - a common cancer that responds best to treatment when detected early

NIH: National Institute of Diabetes and Digestive and Kidney Diseases


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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.


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