ICD-10 Coding for Swollen Testicle(N43.0, N45.1, N44.00)
Complete ICD-10-CM coding and documentation guide for Swollen Testicle. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Swollen Testicle
N43-N45Primary Range
Disorders of the male genital organs
This range includes conditions such as hydrocele, epididymitis, and orchitis, which are common causes of scrotal swelling.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N43.0 | Encysted hydrocele | Use when ultrasound confirms a fluid-filled sac without signs of infection. |
|
| N45.1 | Epididymitis | Use when clinical findings indicate epididymal tenderness and infection. |
|
| N44.00 | Torsion of testis, unspecified | Use when clinical and imaging findings confirm torsion. |
|
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 testicle
Essential facts and insights about Swollen Testicle
Primary ICD-10-CM Codes for swelling testicle
Decision Criteria
clinical Criteria
- Non-tender, fluctuant scrotal mass with positive transillumination.
Applicable To
- Non-tender scrotal swelling
- Transillumination positive
Excludes
- Infected hydrocele (N43.1)
Clinical Validation Requirements
- Ultrasound confirmation of fluid-filled sac
Code-Specific Risks
- Misclassification if infection is present
Coding Notes
- Ensure documentation specifies non-infectious nature.
N45.1 - Epididymitis
Use when clinical findings indicate epididymal tenderness and infection.
Applicable To
- Tender epididymis
- Dysuria
Excludes
- Orchitis without epididymitis (N45.0)
Clinical Validation Requirements
- Tenderness of epididymis
- Positive urine culture
Coding Notes
Document urinary symptoms and culture results.
N44.00 - Torsion of testis, unspecified
Use when clinical and imaging findings confirm torsion.
Applicable To
- Sudden onset scrotal pain
- Absent cremasteric reflex
Clinical Validation Requirements
- Doppler ultrasound showing absent blood flow
Coding Notes
Document time of onset and absence of cremasteric reflex.
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 Testicle to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N43.0.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Increases audit risk., Financial: Potential for claim denials.
Mitigation Strategy
Use checklists for required documentation., Train staff on importance of imaging documentation.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit failures., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies laterality and specific condition.
Impact
Use of unspecified codes increases audit risk.
Mitigation Strategy
Ensure documentation supports specific code selection.
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 Testicle, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Swollen Testicle
Use these documentation templates to ensure complete and accurate documentation for Swollen Testicle. These templates include all required elements for proper coding and billing.
Acute Scrotal Pain
Specialty: UrologyRequired Elements
- History of present illness
- Physical exam findings
- Imaging results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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