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v1.0.0
ICD-10 Guide
ICD-10 CodesN42.83

N42.83

Billable

Cyst of prostate

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/18/2025

Code Description

ICD-10 N42.83 is a billable code used to indicate a diagnosis of cyst of prostate.

Key Diagnostic Point:

A cyst of the prostate is a fluid-filled sac that can develop within the prostate gland. These cysts can be asymptomatic or may cause various urinary symptoms depending on their size and location. Prostate cysts can arise from several conditions, including benign prostatic hyperplasia (BPH), prostatitis, or may be congenital in nature. Patients with prostate cysts may experience symptoms such as difficulty urinating, increased urinary frequency, or pelvic discomfort. The presence of a cyst can also complicate the diagnosis of other prostate disorders, including prostate cancer, necessitating careful evaluation. Diagnostic imaging, such as ultrasound or MRI, is often employed to assess the cyst's characteristics. Additionally, prostate-specific antigen (PSA) levels may be monitored, as elevated levels can indicate underlying pathology. Treatment options vary based on symptoms and may include observation, medication, or surgical intervention if the cyst is symptomatic or associated with other prostate disorders.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other prostate disorders such as BPH and prostatitis.
  • Need for accurate imaging documentation.
  • Potential overlap with prostate cancer diagnoses.
  • Variability in symptoms and treatment approaches.

Audit Risk Factors

  • Inadequate documentation of symptoms related to the cyst.
  • Failure to document imaging studies performed.
  • Misclassification of cysts as malignant without proper evidence.
  • Inconsistent reporting of PSA levels.

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed clinical notes on symptoms, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with urinary symptoms, abnormal PSA levels, or findings on imaging.

Billing Considerations

Ensure clarity in distinguishing cysts from other prostate conditions and document any interventions performed.

Primary Care

Documentation Requirements

Comprehensive history and physical examination notes, including urinary symptoms and referral details.

Common Clinical Scenarios

Routine screening for prostate health, management of urinary symptoms, and referrals to urology.

Billing Considerations

Document any patient education provided regarding prostate health and follow-up plans.

Coding Guidelines

Inclusion Criteria

Use N42.83 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the cyst's characteristics and any associated symptoms
  • Include relevant imaging and laboratory results to support the diagnosis

Exclusion Criteria

Do NOT use N42.83 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

52000CPT Code

Cystoscopy

Clinical Scenario

Used to visualize the bladder and prostate in patients with urinary symptoms.

Documentation Requirements

Document indications for the procedure and findings.

Specialty Considerations

Urologists should ensure that all findings are clearly documented to support the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of prostate conditions, including cysts, which aids in better tracking and management of these conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of prostate conditions, including cysts, which aids in better tracking and management of these conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of prostate conditions, including cysts, which aids in better tracking and management of these conditions.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common symptoms of a prostate cyst?

Common symptoms include urinary frequency, urgency, pelvic pain, and difficulty urinating. However, many cysts can be asymptomatic.