ICD-10 Coding for Swollen Scrotum(N49.2, N43.1, N45.1)
Complete ICD-10-CM coding and documentation guide for Swollen Scrotum. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Swollen Scrotum
N43-N49Primary Range
Disorders of male genital organs
This range includes codes for conditions causing scrotal swelling such as hydrocele, epididymitis, and inflammatory disorders.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N49.2 | Inflammatory disorders of the scrotum | Use when there is confirmed inflammation of the scrotum with supporting clinical findings. |
|
| N43.1 | Infected hydrocele | Use when a hydrocele is confirmed to be infected. |
|
| N45.1 | Epididymitis | Use when there is confirmed inflammation of the epididymis. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for swollen scrotum
Essential facts and insights about Swollen Scrotum
Primary ICD-10-CM Codes for swollen scrotum
Decision Criteria
clinical Criteria
- Presence of scrotal erythema and purulent drainage
Clinical Validation Requirements
- Erythema and warmth of the scrotum
- Purulent drainage
- WBC count >10,000
Code-Specific Risks
- Misclassification if not all criteria are met
- Potential for audit if documentation is insufficient
Coding Notes
- Ensure documentation includes specific symptoms and laboratory findings.
N43.1 - Infected hydrocele
Use when a hydrocele is confirmed to be infected.
Applicable To
- Hydrocele with infection
Excludes
- Non-infected hydrocele (N43.0)
Clinical Validation Requirements
- Positive transillumination test
- Ultrasound confirmation of fluid
- Culture positive for infection
Coding Notes
Document infection status and culture results clearly.
N45.1 - Epididymitis
Use when there is confirmed inflammation of the epididymis.
Applicable To
- Acute epididymitis
Excludes
- Orchitis without epididymitis (N45.0)
Clinical Validation Requirements
- Tenderness of the epididymis
- Positive urinalysis with leukocytes
Coding Notes
Ensure documentation specifies epididymal involvement.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Swollen Scrotum to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N49.2.
Impact
Clinical: Inaccurate treatment records, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Ensure infection is confirmed with lab results, Document all relevant clinical findings
Impact
Reimbursement: May lead to claim denials, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data reporting
Mitigation Strategy
Ensure inflammation is documented with clinical signs and lab results.
Impact
Reimbursement: Potential for reduced reimbursement, Compliance: Failure to meet coding standards, Data Quality: Incomplete patient records
Mitigation Strategy
Always specify laterality using appropriate codes (e.g., N43.01 for right).
Impact
Lack of detailed infection documentation can lead to audits.
Mitigation Strategy
Ensure all infections are documented with culture results and organism identification.
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 Swollen Scrotum, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Swollen Scrotum
Use these documentation templates to ensure complete and accurate documentation for Swollen Scrotum. These templates include all required elements for proper coding and billing.
Acute Scrotal Pain
Specialty: UrologyRequired Elements
- Onset and duration of pain
- Physical exam findings
- Ultrasound results
- Laboratory tests
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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