Coding and coverage · ICD-10-CM

N40

N40.3 Nodular prostate with lower urinary tract symptoms

BillableNo payment HCCChapter 14

Instructional notes

Chapter 14

Excludes2Not included here: the patient may have both; report both when both are present.
  • 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)

N40

Excludes1Not coded here: never report with this code, except when the two conditions are unrelated.
  • benign neoplasms of prostate (adenoma, benign) (fibroadenoma) (fibroma) (myoma) (D29.1)
Excludes2Not included here: the patient may have both; report both when both are present.
  • malignant neoplasm of prostate (C61)
Includes
  • adenofibromatous hypertrophy of prostate
  • benign hypertrophy of the prostate
  • benign prostatic hypertrophy
  • BPH
  • enlarged prostate
  • nodular prostate
  • polyp of prostate

This code

Use additional codeAdd a second code for the full picture.
  • 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)

Chapter 14: Diseases of the genitourinary system · N40-N53 Diseases of male genital organs (N40-N53)

Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.

Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.