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v1.0.0
ICD-10 Guide
ICD-10 CodesN50.81

N50.81

Billable

Testicular pain

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

Code Description

ICD-10 N50.81 is a billable code used to indicate a diagnosis of testicular pain.

Key Diagnostic Point:

Testicular pain, or orchalgia, is a condition characterized by discomfort or pain in one or both testicles. This condition can arise from various etiologies, including trauma, infection, torsion, or referred pain from other pelvic structures. Infections such as epididymitis or orchitis are common causes, often presenting with swelling, redness, and tenderness. Testicular torsion, a surgical emergency, presents with acute onset of severe pain and requires immediate intervention to prevent loss of testicular function. Chronic testicular pain may be associated with conditions like varicocele or hernia. Accurate diagnosis often necessitates a thorough history, physical examination, and potentially imaging studies such as ultrasound. Treatment varies based on the underlying cause and may include antibiotics for infections, pain management, or surgical intervention for torsion. Understanding the multifactorial nature of testicular pain is crucial for effective management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes requiring differential diagnosis
  • Need for precise documentation of symptoms and duration
  • Potential for associated conditions that may complicate coding
  • Variability in clinical presentation among patients

Audit Risk Factors

  • Inadequate documentation of the pain's onset and characteristics
  • Failure to document associated symptoms or findings
  • Misdiagnosis leading to incorrect coding
  • Lack of supporting imaging or lab results

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed history of present illness, physical exam findings, and any imaging results.

Common Clinical Scenarios

Patients presenting with acute scrotal pain, chronic testicular discomfort, or post-operative pain.

Billing Considerations

Urologists must document the specific nature of the pain and any interventions performed.

Primary Care

Documentation Requirements

Comprehensive history and physical exam, including any referrals made to specialists.

Common Clinical Scenarios

Patients with testicular pain presenting in a primary care setting, often requiring initial evaluation.

Billing Considerations

Primary care providers should ensure thorough documentation to support referrals and potential diagnoses.

Coding Guidelines

Inclusion Criteria

Use N50.81 When
  • According to ICD
  • 10 guidelines, N50
  • 81 should be used when the primary diagnosis is testicular pain without a more specific underlying condition documented
  • Coders should ensure that the documentation supports the diagnosis and that any associated conditions are coded separately

Exclusion Criteria

Do NOT use N50.81 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

54160CPT Code

Testicular exploration

Clinical Scenario

Used when surgical intervention is required for conditions like torsion.

Documentation Requirements

Operative report detailing findings and interventions.

Specialty Considerations

Urologists must ensure that the procedure is well-documented to support the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of testicular pain, improving the ability to capture the complexity of the condition and its underlying causes. This specificity aids in better patient management and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of testicular pain, improving the ability to capture the complexity of the condition and its underlying causes. This specificity aids in better patient management and resource allocation.

Reimbursement & Billing Impact

reimbursement and to avoid claim denials.

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 should I document to support the use of N50.81?

Document the onset, duration, severity, and characteristics of the pain, along with any associated symptoms and findings from physical examination or imaging.