D07.5 vs N42
D07.5 and N42 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on D07.5
dysplasia (mild) (moderate) of prostate (N42.3-)
D07.5
Carcinoma in situ of prostate
Billable
- Chapter 2
- Neoplasms
- Section
- D00-D09
Use when the record says
- Prostatic intraepithelial neoplasia III (PIN III)
- Severe dysplasia of prostate
Indexed under
- Dysplasia › prostate › severe
- Neoplasia › intraepithelial › prostate › grade III
N42
Other and unspecified disorders of prostate
Not billable
- Chapter 14
- Diseases of the genitourinary system
- Section
- N40-N53
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027