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ICD-10 Guide
ICD-10 CodesN43.41

N43.41

Billable

Spermatocele of epididymis, single

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

Code Description

ICD-10 N43.41 is a billable code used to indicate a diagnosis of spermatocele of epididymis, single.

Key Diagnostic Point:

A spermatocele is a fluid-filled cyst that develops in the epididymis, which is a coiled tube located at the back of the testicle responsible for storing and maturing sperm. A single spermatocele typically arises from the obstruction of the epididymal duct, leading to the accumulation of sperm and fluid. These cysts are usually benign and asymptomatic, but they can sometimes cause discomfort or pain, particularly if they grow large. Diagnosis is often made through physical examination and imaging studies such as ultrasound, which can help differentiate a spermatocele from other testicular masses. Treatment is generally not required unless the spermatocele causes significant discomfort or complications, in which case surgical intervention may be considered. Understanding the implications of a spermatocele is crucial in the context of male reproductive health, as it may be associated with other conditions such as hydrocele, orchitis, or male infertility. Proper management and follow-up are essential to ensure that any underlying issues are addressed.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other testicular disorders such as hydrocele and orchitis.
  • Potential overlap with male infertility evaluations.
  • Variability in clinical presentation and symptoms.
  • Need for imaging studies to confirm diagnosis.

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings.
  • Failure to document imaging studies that support the diagnosis.
  • Misclassification of spermatocele as a malignant condition.
  • Lack of follow-up documentation for treatment outcomes.

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

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

Common Clinical Scenarios

Evaluation of scrotal masses, management of male infertility, and follow-up of benign testicular conditions.

Billing Considerations

Ensure accurate differentiation from other testicular conditions and document any associated symptoms or complications.

Andrology

Documentation Requirements

Comprehensive assessment of male reproductive health, including hormonal evaluations and fertility assessments.

Common Clinical Scenarios

Assessment of male infertility, management of spermatic cord disorders, and counseling on reproductive options.

Billing Considerations

Focus on the impact of spermatocele on fertility and the need for potential surgical intervention.

Coding Guidelines

Inclusion Criteria

Use N43.41 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the diagnosis, associated symptoms, and any imaging studies performed
  • Include relevant history and physical examination findings to support the diagnosis

Exclusion Criteria

Do NOT use N43.41 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

55040CPT Code

Excision of spermatocele

Clinical Scenario

Used when a spermatocele causes significant discomfort and surgical intervention is required.

Documentation Requirements

Document the indication for surgery, pre-operative assessments, and post-operative care.

Specialty Considerations

Urologists should ensure that the surgical necessity is well-documented.

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 spermatocele, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of male reproductive health issues.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like spermatocele, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of male reproductive health issues.

Reimbursement & Billing Impact

reimbursement processes. It has also facilitated better tracking of male reproductive health issues.

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 spermatocele and a hydrocele?

A spermatocele is a cyst that contains sperm and fluid, typically located in the epididymis, while a hydrocele is a fluid-filled sac around the testicle that does not contain sperm. Diagnosis is made through physical examination and imaging.