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v1.0.0
ICD-10 Guide
ICD-10 CodesN45.2

N45.2

Billable

Orchitis

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

Code Description

ICD-10 N45.2 is a billable code used to indicate a diagnosis of orchitis.

Key Diagnostic Point:

Orchitis is an inflammation of one or both testicles, often resulting from viral or bacterial infections. The condition can be acute or chronic and may present with symptoms such as swelling, pain, and tenderness in the affected testicle(s). Orchitis can occur as a complication of other infections, such as mumps, or sexually transmitted infections like gonorrhea and chlamydia. In some cases, it may be associated with conditions like hydrocele, where fluid accumulates around the testicle, leading to additional discomfort and swelling. Orchitis can also impact male fertility, as inflammation may affect sperm production and transport. Diagnosis typically involves a physical examination, ultrasound imaging, and laboratory tests to identify the underlying cause. Treatment may include antibiotics for bacterial infections, pain management, and in some cases, surgical intervention. Understanding orchitis is crucial for andrological management, particularly in addressing male infertility and penile disorders that may arise from or be exacerbated by this condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between viral and bacterial causes
  • Potential overlap with other testicular disorders
  • Impact on male fertility and associated conditions
  • Variability in presentation and severity

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to specify the underlying cause of orchitis
  • Misclassification of orchitis as a non-specific testicular disorder
  • Lack of follow-up documentation regarding treatment outcomes

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed clinical notes including patient history, physical examination findings, and diagnostic test results.

Common Clinical Scenarios

Patients presenting with acute scrotal pain, swelling, or infertility concerns.

Billing Considerations

Ensure clear documentation of the cause of orchitis and any associated conditions to support coding.

Andrology

Documentation Requirements

Comprehensive assessment of male reproductive health, including fertility evaluations.

Common Clinical Scenarios

Men seeking evaluation for infertility or presenting with testicular pain.

Billing Considerations

Focus on the impact of orchitis on fertility and the need for potential interventions.

Coding Guidelines

Inclusion Criteria

Use N45.2 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the condition's etiology and any associated complications
  • Include relevant clinical findings and treatment plans

Exclusion Criteria

Do NOT use N45.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

54500CPT Code

Testicular biopsy

Clinical Scenario

When orchitis is suspected to have a non-infectious etiology.

Documentation Requirements

Document indications for biopsy and findings.

Specialty Considerations

Urologists should ensure clear justification for the procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of orchitis, improving the ability to capture the nuances of the condition and its complications, which can enhance patient care and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of orchitis, improving the ability to capture the nuances of the condition and its complications, which can enhance patient care and treatment planning.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of orchitis, improving the ability to capture the nuances of the condition and its complications, which can enhance patient care and treatment planning.

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 orchitis?

Common causes include viral infections like mumps, bacterial infections from sexually transmitted diseases, and complications from other infections.

How does orchitis affect male fertility?

Orchitis can lead to inflammation that affects sperm production and transport, potentially resulting in infertility.