ICD-10 Coding for Benign Prostatic Hyperplasia with Lower Urinary Tract Symptoms(N40.1)
Complete ICD-10-CM coding and documentation guide for Benign Prostatic Hyperplasia with Lower Urinary Tract Symptoms. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Benign Prostatic Hyperplasia with Lower Urinary Tract Symptoms
N40-N51Primary Range
Diseases of male genital organs
This range includes codes for benign prostatic hyperplasia and related conditions.
Key Information: ICD-10 code for BPH with LUTS
Essential facts and insights about Benign Prostatic Hyperplasia with Lower Urinary Tract Symptoms
Primary ICD-10-CM Code for benign prostatic hypertrophy with luts
Decision Criteria
clinical Criteria
- Presence of LUTS such as nocturia or weak stream.
documentation Criteria
- Detailed documentation of LUTS and IPSS score.
Applicable To
- BPH with LUTS
- Benign prostatic hypertrophy with LUTS
Clinical Validation Requirements
- IPSS score ≥8
- Uroflowmetry showing Qmax <10 mL/sec
- Post-Void Residual (PVR) >100 mL
Code-Specific Risks
- Risk of using unspecified code N40 leading to denials.
- Failure to document specific LUTS can result in incorrect coding.
Coding Notes
- Ensure documentation explicitly mentions LUTS and pairs with appropriate symptom codes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Benign Prostatic Hyperplasia with Lower Urinary Tract Symptoms to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N40.1.
Impact
Clinical: Incomplete clinical picture., Regulatory: Potential audit risk., Financial: Possible claim denials.
Mitigation Strategy
Always pair N40.1 with relevant symptom codes.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure LUTS are documented and use N40.1.
Impact
Failure to document specific LUTS can lead to audits.
Mitigation Strategy
Ensure detailed documentation of LUTS and IPSS scores.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Benign Prostatic Hyperplasia with Lower Urinary Tract Symptoms, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Benign Prostatic Hyperplasia with Lower Urinary Tract Symptoms
Use these documentation templates to ensure complete and accurate documentation for Benign Prostatic Hyperplasia with Lower Urinary Tract Symptoms. These templates include all required elements for proper coding and billing.
Initial evaluation of BPH with LUTS
Specialty: UrologyRequired Elements
- IPSS score
- Uroflowmetry results
- Prostate size on imaging
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Benign Prostatic Hyperplasia with Lower Urinary Tract Symptoms? Ask your questions below.