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ICD-10 Guide
ICD-10 CodesN52.03

N52.03

Billable

Combined arterial insufficiency and corporo-venous occlusive erectile dysfunction

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

Code Description

ICD-10 N52.03 is a billable code used to indicate a diagnosis of combined arterial insufficiency and corporo-venous occlusive erectile dysfunction.

Key Diagnostic Point:

Combined arterial insufficiency and corporo-venous occlusive erectile dysfunction is a complex condition characterized by the simultaneous presence of arterial insufficiency and venous occlusion affecting erectile function in males. Arterial insufficiency refers to inadequate blood flow to the penis due to narrowed or blocked arteries, which can result from atherosclerosis, diabetes, or other vascular diseases. Corporo-venous occlusive dysfunction occurs when the veins that drain blood from the penis fail to constrict properly during erection, leading to premature detumescence. This dual pathology can significantly impair the ability to achieve or maintain an erection, affecting sexual health and quality of life. Diagnosis typically involves a thorough medical history, physical examination, and may include Doppler ultrasound or other vascular studies to assess blood flow and venous function. Treatment options may include lifestyle modifications, pharmacotherapy, vacuum erection devices, or surgical interventions, depending on the underlying causes and severity of the dysfunction.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of both arterial and venous mechanisms of erectile dysfunction.
  • Involves multiple underlying conditions that may contribute to the diagnosis.
  • Documentation must clearly differentiate between types of erectile dysfunction.
  • Potential for overlapping symptoms with other sexual dysfunction codes.

Audit Risk Factors

  • Inadequate documentation of the underlying causes of erectile dysfunction.
  • Failure to specify the type of erectile dysfunction being treated.
  • Lack of supporting diagnostic tests in the medical record.
  • Misclassification of erectile dysfunction types leading to incorrect coding.

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed patient history, physical examination findings, and results from diagnostic tests such as penile Doppler ultrasound.

Common Clinical Scenarios

Evaluation of patients presenting with erectile dysfunction, particularly those with known vascular risk factors.

Billing Considerations

Urologists must ensure that the documentation clearly indicates the type of erectile dysfunction and any contributing factors.

Endocrinology

Documentation Requirements

Assessment of hormonal levels, particularly testosterone, and management of diabetes or other metabolic conditions.

Common Clinical Scenarios

Management of erectile dysfunction in patients with diabetes or hormonal imbalances.

Billing Considerations

Endocrinologists should document the relationship between hormonal levels and erectile function.

Coding Guidelines

Inclusion Criteria

Use N52.03 When
  • According to ICD
  • 10 guidelines, this code should be used when both arterial insufficiency and corporo
  • venous occlusive dysfunction are documented
  • Coders must ensure that the documentation supports the diagnosis and that other potential causes of erectile dysfunction are ruled out

Exclusion Criteria

Do NOT use N52.03 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

CPT 54400CPT Code

Penile prosthesis implantation

Clinical Scenario

Used in cases where conservative treatments fail for erectile dysfunction.

Documentation Requirements

Pre-operative evaluations, including vascular studies and patient consent.

Specialty Considerations

Urologists must document the rationale for surgical intervention.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of erectile dysfunction, enabling better tracking of the condition's prevalence and associated comorbidities. N52.03 provides a detailed classification that reflects the complexity of the condition, improving the accuracy of healthcare data.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of erectile dysfunction, enabling better tracking of the condition's prevalence and associated comorbidities. N52.03 provides a detailed classification that reflects the complexity of the condition, improving the accuracy of healthcare data.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of erectile dysfunction, enabling better tracking of the condition's prevalence and associated comorbidities. N52.03 provides a detailed classification that reflects the complexity of the condition, improving the accuracy of healthcare data.

Resources

Clinical References

  • •
    American Urological Association Guidelines on Erectile Dysfunction

Coding & Billing References

  • •
    American Urological Association Guidelines on Erectile Dysfunction

Frequently Asked Questions

What is the difference between N52.03 and other erectile dysfunction codes?

N52.03 specifically indicates the presence of both arterial insufficiency and corporo-venous occlusive dysfunction, making it a more complex diagnosis than codes that address only one of these issues.