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ICD-10 Guide
ICD-10 CodesN52.1

N52.1

Billable

Erectile dysfunction due to diseases classified elsewhere

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

Code Description

ICD-10 N52.1 is a billable code used to indicate a diagnosis of erectile dysfunction due to diseases classified elsewhere.

Key Diagnostic Point:

Erectile dysfunction (ED) is a condition characterized by the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. When classified under N52.1, it indicates that the ED is secondary to other underlying diseases, which may include conditions such as diabetes mellitus, cardiovascular diseases, neurological disorders, or hormonal imbalances. These diseases can affect the vascular, neurological, or hormonal pathways necessary for achieving an erection. For instance, diabetes can lead to neuropathy and vascular damage, while hormonal disorders can disrupt testosterone levels, both of which can contribute to ED. Accurate diagnosis and identification of the underlying condition are crucial for effective treatment and management of ED. Treatment may involve addressing the primary disease, lifestyle modifications, pharmacotherapy, or other interventions aimed at restoring erectile function. Understanding the interplay between these diseases and erectile dysfunction is essential for healthcare providers to offer comprehensive care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires knowledge of multiple underlying conditions that can cause ED.
  • Differentiating between primary ED and secondary ED due to other diseases.
  • Need for comprehensive patient history and documentation of comorbidities.
  • Potential for overlapping symptoms with other sexual dysfunction codes.

Audit Risk Factors

  • Inadequate documentation of the underlying disease.
  • Failure to link ED to the primary condition in medical records.
  • Misclassification of primary versus secondary ED.
  • Lack of detailed patient history regarding sexual health.

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed patient history, including sexual health history and comorbid conditions.

Common Clinical Scenarios

Patients presenting with ED who have a history of diabetes or cardiovascular disease.

Billing Considerations

Urologists must ensure that the underlying causes of ED are thoroughly evaluated and documented.

Endocrinology

Documentation Requirements

Thorough assessment of hormonal levels and related conditions.

Common Clinical Scenarios

Patients with hormonal imbalances presenting with ED.

Billing Considerations

Endocrinologists should document the relationship between hormonal disorders and sexual dysfunction.

Coding Guidelines

Inclusion Criteria

Use N52.1 When
  • According to ICD
  • 10 guidelines, N52
  • 1 should be used when erectile dysfunction is a direct result of another disease
  • Coders must ensure that the primary condition is also documented and coded appropriately

Exclusion Criteria

Do NOT use N52.1 When
  • Exclusion criteria include cases where ED is not linked to another disease

Related ICD-10 Codes

Related CPT Codes

54160CPT Code

Insertion of penile prosthesis

Clinical Scenario

Used in cases where ED is severe and unresponsive to other treatments.

Documentation Requirements

Detailed medical history, previous treatments attempted, and rationale for surgery.

Specialty Considerations

Urologists must document the failure of conservative treatments before proceeding.

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, particularly in cases where it is secondary to other diseases. This specificity aids in better understanding the prevalence and treatment of ED in relation to other health conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of erectile dysfunction, particularly in cases where it is secondary to other diseases. This specificity aids in better understanding the prevalence and treatment of ED in relation to other health conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of erectile dysfunction, particularly in cases where it is secondary to other diseases. This specificity aids in better understanding the prevalence and treatment of ED in relation to other health conditions.

Resources

Clinical References

  • •
    American Urological Association Guidelines

Coding & Billing References

  • •
    American Urological Association Guidelines

Frequently Asked Questions

What are the common causes of erectile dysfunction classified under N52.1?

Common causes include diabetes, cardiovascular diseases, neurological disorders, and hormonal imbalances. Each of these conditions can affect the physiological mechanisms necessary for achieving and maintaining an erection.