N40.1 — Benign prostatic hyperplasia with lower urinary tract symptoms
Is N40.1 billable?
Yes — N40.1 is billable for FY2027. N40.1 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. N40.1 may be submitted for encounters from October 1, 2026 through September 30, 2027.
N40.1 at a glance
| Code | N40.1 |
|---|---|
| Description | Benign prostatic hyperplasia with lower urinary tract symptoms |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does N40.1 group to?
N40.1 sits in MDC 12 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 725Benign Prostatic Hypertrophy with MCCmedical
- 726Benign Prostatic Hypertrophy without MCCmedical
How is N40.1 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to N40.1. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Enlargement, enlarged › prostate › with lower urinary tract symptoms
- Hyperplasia, hyperplastic › prostate › with lower urinary tract symptoms
Use additional code
Report an additional code alongside N40.1 to fully describe the condition. N40.1 is sequenced first.
- code for associated symptoms, when specified:
- incomplete bladder emptying (R39.14)
- nocturia (R35.1)
- straining on urination (R39.16)
- urinary frequency (R35.0)
- urinary hesitancy (R39.11)
- urinary incontinence (N39.4-)
- urinary obstruction (N13.8)
- urinary retention (R33.8)
- urinary urgency (R39.15)
- weak urinary stream (R39.12)
Inclusion terms
Alternative wording in documentation that is classified to N40.1.
- Enlarged prostate with LUTS
Excludes1 — never code together — inherited from N40
The conditions below can never be reported together with N40.1 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- benign neoplasms of prostate (adenoma, benign) (fibroadenoma) (fibroma) (myoma) (D29.1)
Excludes2 — not included here — inherited from Chapter 14
The conditions below are not part of N40.1, but a patient may have both at the same time. When documentation supports it, N40.1 and the excluded code may both be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Excludes2 — not included here — inherited from N40
The conditions below are not part of N40.1, but a patient may have both at the same time. When documentation supports it, N40.1 and the excluded code may both be reported.
- malignant neoplasm of prostate (C61)
How long has N40.1 existed?
N40.1 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
- FY2018Enlarged prostate with lower urinary tract symptomsBenign prostatic hyperplasia with lower urinary tract symptoms
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.