Is ICD-10-CM code N43 billable?

No, N43 (Hydrocele and spermatocele) 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 N43 belong to?

N43 belongs to Chapter 14 of the ICD-10-CM tabular list: N00–N99 (Diseases of the Genitourinary System).

N43Not billable, use a more specific code below

Hydrocele and spermatocele

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

7 billable codes under N43: 1 is a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.

Instructional notes

Includes: conditions that are coded here

hydrocele of spermatic cord, testis or tunica vaginalis

Excludes1: not coded here, use a different code

congenital hydrocele (P83.5)

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 N43

N43 can't be used on a claim. Pick a billable code below; grey headings group them.

N43 MS-DRGs

As the principal diagnosis, the billable codes under N43 group to MS-DRG 729, 730, 727, or 728 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 729 Other Male Reproductive System Diagnoses with CC/MCC (6 of 7 codes)
DRG 730 Other Male Reproductive System Diagnoses without CC/MCC (6 of 7 codes)
DRG 727 Inflammation of the Male Reproductive System with MCC (1 of 7 codes)
DRG 728 Inflammation of the Male Reproductive System without MCC (1 of 7 codes)

About the condition

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

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.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.