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v1.0.0
ICD-10 Guide
ICD-10 CodesN43.2

N43.2

Billable

Other hydrocele

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

Code Description

ICD-10 N43.2 is a billable code used to indicate a diagnosis of other hydrocele.

Key Diagnostic Point:

Hydrocele is a condition characterized by the accumulation of serous fluid in the tunica vaginalis, the pouch of serous membrane surrounding the testis. While hydroceles can be classified as either communicating or non-communicating, the term 'other hydrocele' (N43.2) encompasses cases that do not fit neatly into these categories or are due to less common etiologies. Hydroceles can arise from various causes, including trauma, infection, or inflammation, and may be associated with other testicular disorders such as orchitis or epididymitis. Symptoms typically include swelling in the scrotum, which may be painless or associated with discomfort. In some cases, hydroceles can lead to complications such as testicular torsion or infertility, particularly if they are large or persist over time. Diagnosis is usually made through physical examination and imaging studies, such as ultrasound, which can help differentiate hydroceles from other scrotal masses. Treatment options vary based on the underlying cause and severity of symptoms, ranging from observation to surgical intervention, such as hydrocelectomy. Proper management is crucial to prevent complications and address any associated reproductive health issues.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes leading to hydrocele
  • Differentiation from other scrotal masses
  • Potential association with male infertility
  • Variability in treatment approaches

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to specify the type of hydrocele
  • Lack of supporting imaging studies
  • Inconsistent coding of associated conditions

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed clinical history, physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Evaluation of scrotal swelling, management of post-traumatic hydrocele, and assessment of hydrocele in the context of infertility.

Billing Considerations

Urologists should ensure that all relevant diagnostic tests are documented to support the diagnosis and any surgical interventions.

Andrology

Documentation Requirements

Comprehensive assessment of male reproductive health, including semen analysis and hormonal evaluations.

Common Clinical Scenarios

Assessment of hydrocele in patients presenting with infertility or erectile dysfunction.

Billing Considerations

Andrologists must document any potential impact of hydrocele on fertility and related treatments.

Coding Guidelines

Inclusion Criteria

Use N43.2 When
  • According to ICD
  • 10 guidelines, N43
  • 2 should be used when the hydrocele does not fit into the defined categories of communicating or non
  • communicating
  • Coders must ensure that the diagnosis is supported by clinical documentation and that any associated conditions are also coded appropriately

Exclusion Criteria

Do NOT use N43.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

55040CPT Code

Hydrocelectomy

Clinical Scenario

Performed when a hydrocele is symptomatic or large.

Documentation Requirements

Pre-operative assessment, consent, and post-operative follow-up notes.

Specialty Considerations

Urologists should document the indication for surgery and any complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hydroceles, improving the accuracy of data collection and reimbursement processes. The granularity of ICD-10 codes helps in better tracking of patient outcomes and resource utilization.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hydroceles, improving the accuracy of data collection and reimbursement processes. The granularity of ICD-10 codes helps in better tracking of patient outcomes and resource utilization.

Reimbursement & Billing Impact

reimbursement processes. The granularity of ICD-10 codes helps in better tracking of patient outcomes and resource utilization.

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 is the difference between a communicating and non-communicating hydrocele?

A communicating hydrocele occurs when there is a patent processus vaginalis allowing fluid to move between the abdominal cavity and the scrotum, while a non-communicating hydrocele is due to fluid accumulation without this connection.