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ICD-10 Guide
ICD-10 CodesN49.9

N49.9

Billable

Inflammatory disorder of unspecified male genital organ

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

Code Description

ICD-10 N49.9 is a billable code used to indicate a diagnosis of inflammatory disorder of unspecified male genital organ.

Key Diagnostic Point:

N49.9 refers to inflammatory disorders affecting the male genital organs that are not specified. This encompasses a range of conditions including hydrocele, orchitis, and other testicular disorders. Hydrocele, characterized by fluid accumulation around the testicle, may present with swelling and discomfort. Orchitis, an inflammation of the testis, can result from infections, trauma, or autoimmune conditions, often leading to pain and potential fertility issues. Male infertility can be linked to inflammatory disorders affecting sperm production or transport. Penile disorders, such as balanitis or penile inflammation, may also fall under this code when inflammation is present without a specific diagnosis. The management of these conditions often requires a multidisciplinary approach, including urologists and andrologists, to address both the inflammatory process and any resultant complications, such as infertility or chronic pain.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes for inflammation
  • Overlap with other male genital disorders
  • Need for detailed clinical documentation
  • Potential for multiple co-existing conditions

Audit Risk Factors

  • Insufficient documentation of symptoms
  • Lack of specificity in diagnosis
  • Inconsistent coding practices across providers
  • Failure to document co-existing conditions

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with scrotal swelling, pain, or infertility issues.

Billing Considerations

Ensure all relevant diagnostic tests (e.g., ultrasound) are documented to support the diagnosis.

Andrology

Documentation Requirements

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

Common Clinical Scenarios

Evaluation of male infertility linked to inflammatory conditions.

Billing Considerations

Document any treatments or interventions that may impact fertility outcomes.

Coding Guidelines

Inclusion Criteria

Use N49.9 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • 9 should be used when the specific inflammatory disorder is not identified
  • Ensure to document any related conditions that may impact treatment

Exclusion Criteria

Do NOT use N49.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

54500CPT Code

Testicular aspiration

Clinical Scenario

Used in cases of hydrocele or suspected testicular masses.

Documentation Requirements

Document indication for aspiration and findings.

Specialty Considerations

Urologists should ensure proper technique and follow-up care.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of male genital disorders, improving specificity and accuracy in billing and clinical documentation. N49.9 provides a broader category for unspecified inflammatory conditions, which can help capture a wider range of clinical scenarios.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of male genital disorders, improving specificity and accuracy in billing and clinical documentation. N49.9 provides a broader category for unspecified inflammatory conditions, which can help capture a wider range of clinical scenarios.

Reimbursement & Billing Impact

billing and clinical documentation. N49.9 provides a broader category for unspecified inflammatory conditions, which can help capture a wider range of clinical scenarios.

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

When should I use N49.9?

Use N49.9 when there is an inflammatory disorder of the male genital organ that is not specified. Ensure that the clinical documentation supports this diagnosis.