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v1.0.0
ICD-10 Guide
ICD-10 CodesN43.3

N43.3

Billable

Hydrocele, unspecified

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

Code Description

ICD-10 N43.3 is a billable code used to indicate a diagnosis of hydrocele, unspecified.

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. This condition can occur in one or both testicles and is often asymptomatic, although it may present with swelling in the scrotum. Hydroceles can be classified as communicating or non-communicating, with the former being associated with a patent processus vaginalis. While hydroceles are generally benign, they can sometimes indicate underlying conditions such as testicular torsion or tumors. Diagnosis typically involves physical examination and may be confirmed through ultrasound imaging. Treatment options vary based on the severity of symptoms and may include observation, aspiration, or surgical intervention. In the context of male infertility, hydroceles can potentially affect sperm production and quality, necessitating thorough evaluation and management by andrologists. Understanding hydrocele is crucial for addressing related testicular disorders, orchitis, and penile disorders, as these conditions can co-occur and complicate the clinical picture.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation between communicating and non-communicating hydrocele
  • Potential association with other testicular disorders
  • Variability in presentation and symptoms
  • Need for imaging studies for accurate diagnosis

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to specify the type of hydrocele
  • Lack of imaging results in the medical record
  • Inconsistent coding with treatment provided

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

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

Common Clinical Scenarios

Evaluation of scrotal swelling, management of hydrocele post-surgery, and assessment of infertility related to hydrocele.

Billing Considerations

Urologists must ensure that all relevant diagnostic tests are documented to support the coding of hydrocele.

Andrology

Documentation Requirements

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

Common Clinical Scenarios

Assessment of male infertility cases where hydrocele is present, and management of associated conditions.

Billing Considerations

Andrologists should document the impact of hydrocele on fertility to justify treatment interventions.

Coding Guidelines

Inclusion Criteria

Use N43.3 When
  • 10 coding guidelines specify that hydrocele codes should be used when the condition is confirmed through clinical evaluation

Exclusion Criteria

Do NOT use N43.3 When
  • Exclusion criteria include conditions that are not hydroceles or are better classified under other specific codes

Related ICD-10 Codes

Related CPT Codes

55040CPT Code

Hydrocelectomy

Clinical Scenario

Performed when a hydrocele is symptomatic or large.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Urologists must document the indication for surgery clearly.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hydrocele, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hydrocele, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 communicating and non-communicating hydrocele?

Communicating hydrocele occurs when there is a connection between the abdominal cavity and the scrotum, allowing fluid to move freely. Non-communicating hydrocele does not have this connection and is typically due to fluid accumulation without a direct link to the abdominal cavity.