Is ICD-10-CM code N40 billable?

No, N40 (Benign prostatic hyperplasia) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code N40 belong to?

N40 belongs to Chapter 14 of the ICD-10-CM tabular list: N00–N99 (Diseases of the Genitourinary System).

N40Not billable, use a more specific code below

Benign prostatic hyperplasia

In Diseases of male genital organs (N40-N53), chapter 14: Diseases of the Genitourinary System

4 billable codes under N40: none are a CC or MCC; none map to an HCC.

Instructional notes

Includes: conditions that are coded here

adenofibromatous hypertrophy of prostate
benign hypertrophy of the prostate
benign prostatic hypertrophy
BPH
enlarged prostate
nodular prostate
polyp of prostate

Excludes1: not coded here, use a different code

benign neoplasms of prostate (adenoma, benign) (fibroadenoma) (fibroma) (myoma) (D29.1)

Excludes2: not included here, code separately if applicable

malignant neoplasm of prostate (C61)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers chronic kidney disease staging, CKD in kidney transplant patients, and sequencing CKD with related conditions such as diabetes and hypertension.

Chronic kidney disease (page 62)

Read Section I.C.14 (page 62)

All codes under N40

N40 can't be used on a claim. Pick a billable code below; grey headings group them.

N40 MS-DRGs

As the principal diagnosis, all 4 billable codes under N40 group to MS-DRG 725 or 726 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

Other codes that refer to N40

Notes on these codes point to N40.

D29.1 Excludes1: enlarged prostate (N40.-)
N42.1 Excludes1: enlarged prostate (N40.-)
N42.1 Excludes1: hyperplasia of prostate (N40.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

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. An enlarged prostate is when your prostate gland becomes larger than normal. It's also called benign prostatic hyperplasia or BPH for short. Benign means not cancer. And hyperplasia means too much cell growth. BPH isn't cancer and it doesn't increase your risk of getting prostate cancer.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015.

FY2017: Title changed. It was: Enlarged prostate.