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v1.0.0
ICD-10 Guide
ICD-10 CodesN43.1

N43.1

Billable

Infected hydrocele

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

Code Description

ICD-10 N43.1 is a billable code used to indicate a diagnosis of infected hydrocele.

Key Diagnostic Point:

An infected hydrocele is a pathological condition characterized by the accumulation of fluid in the tunica vaginalis surrounding the testis, which becomes infected. This condition often arises from an underlying testicular disorder, such as orchitis or trauma, leading to inflammation and subsequent infection. Patients typically present with swelling in the scrotum, which may be painful and tender to the touch. Symptoms can include fever, erythema, and warmth over the affected area. The infection can be caused by various pathogens, including bacteria, and may require antibiotic treatment. Infected hydroceles can lead to complications such as abscess formation or chronic pain, and they may impact male fertility if left untreated. Diagnosis is usually confirmed through physical examination and imaging studies, such as ultrasound, which can help differentiate between a hydrocele and other scrotal masses. Management may involve surgical intervention, particularly if the hydrocele is large or symptomatic, and drainage may be necessary to relieve pressure and treat the infection effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between infected and non-infected hydrocele
  • Understanding associated conditions like orchitis and their implications
  • Variability in presentation and symptoms among patients
  • Need for accurate documentation of clinical findings and treatment plans

Audit Risk Factors

  • Inadequate documentation of infection severity
  • Failure to document associated symptoms or conditions
  • Misclassification of hydrocele type
  • Lack of follow-up documentation post-treatment

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed clinical notes on symptoms, physical examination findings, and imaging results.

Common Clinical Scenarios

Patients presenting with scrotal swelling, pain, and signs of infection.

Billing Considerations

Ensure clear documentation of the infection's origin and any associated testicular disorders.

Primary Care

Documentation Requirements

Comprehensive history and physical examination notes, including any referrals to specialists.

Common Clinical Scenarios

Initial evaluation of scrotal swelling and management of mild infections.

Billing Considerations

Document any patient history of trauma or previous infections that may contribute to the current condition.

Coding Guidelines

Inclusion Criteria

Use N43.1 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the infection and any related conditions
  • Include details on the patient's history, physical examination findings, and treatment plans to support the diagnosis

Exclusion Criteria

Do NOT use N43.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

55040CPT Code

Scrotal exploration

Clinical Scenario

Used when surgical intervention is necessary for infected hydrocele.

Documentation Requirements

Document indications for surgery, findings during the procedure, and post-operative care.

Specialty Considerations

Urologists should ensure all surgical notes are detailed and include patient consent.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like infected hydrocele, improving the accuracy of patient records and treatment plans. This specificity aids in better tracking of outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like infected hydrocele, improving the accuracy of patient records and treatment plans. This specificity aids in better tracking of outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like infected hydrocele, improving the accuracy of patient records and treatment plans. This specificity aids in better tracking of outcomes and resource allocation.

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 causes of infected hydrocele?

Infected hydrocele can be caused by bacterial infections, often stemming from urinary tract infections, skin infections, or complications from trauma or surgery. Conditions like orchitis can also lead to infection.