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ICD-10 Guide
ICD-10 CodesN46.121

N46.121

Billable

Oligospermia due to drug therapy

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

Code Description

ICD-10 N46.121 is a billable code used to indicate a diagnosis of oligospermia due to drug therapy.

Key Diagnostic Point:

Oligospermia, defined as a lower than normal sperm count in semen, can be a significant factor in male infertility. When oligospermia is attributed to drug therapy, it indicates that certain medications have adversely affected sperm production or quality. Common drugs associated with this condition include anabolic steroids, certain antibiotics, and medications for hypertension or cancer. The pathophysiology often involves hormonal imbalances or direct toxicity to the testes, leading to impaired spermatogenesis. Clinicians must consider the patient's medication history, including over-the-counter drugs and supplements, when diagnosing and managing oligospermia. Treatment may involve discontinuation or adjustment of the offending medication, lifestyle modifications, and possibly assisted reproductive technologies if natural conception is not achievable. Understanding the interplay between drug therapy and male reproductive health is crucial for effective management and counseling of affected patients.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires knowledge of specific medications that can cause oligospermia.
  • Involves understanding of male reproductive physiology.
  • Documentation must clearly link drug therapy to oligospermia.
  • Potential for overlapping diagnoses with other male infertility codes.

Audit Risk Factors

  • Inadequate documentation linking drug therapy to oligospermia.
  • Failure to include a complete medication history.
  • Misclassification of oligospermia as primary infertility without proper evaluation.
  • Lack of follow-up documentation on treatment response.

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed patient history, including medication use, and results from semen analysis.

Common Clinical Scenarios

Evaluation of male infertility, management of testicular disorders, and treatment of orchitis.

Billing Considerations

Urologists should ensure that all relevant medications are documented, and the impact on fertility is discussed with the patient.

Endocrinology

Documentation Requirements

Hormonal assessments and detailed medication history.

Common Clinical Scenarios

Management of hormonal imbalances affecting fertility and assessment of drug-induced side effects.

Billing Considerations

Endocrinologists must correlate hormonal levels with oligospermia and consider alternative therapies.

Coding Guidelines

Inclusion Criteria

Use N46.121 When
  • According to ICD
  • 10 guidelines, N46
  • 121 should be used when oligospermia is specifically linked to drug therapy
  • Coders must ensure that the documentation supports this connection and that other potential causes of oligospermia are ruled out

Exclusion Criteria

Do NOT use N46.121 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

89320CPT Code

Semen analysis

Clinical Scenario

Used to evaluate sperm count in patients suspected of oligospermia.

Documentation Requirements

Results of the semen analysis must be documented in the patient's medical record.

Specialty Considerations

Urologists and reproductive endocrinologists should ensure that the analysis is comprehensive.

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 oligospermia, enabling better tracking of drug-related infertility issues. This specificity aids in research and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like oligospermia, enabling better tracking of drug-related infertility issues. This specificity aids in research and treatment planning.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American Urological Association Guidelines

Coding & Billing References

  • •
    American Urological Association Guidelines

Frequently Asked Questions

What medications are commonly associated with oligospermia?

Common medications include anabolic steroids, certain antihypertensives, and some antibiotics. It's important to review the patient's complete medication history to identify potential causes.