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v1.0.0
ICD-10 Guide
ICD-10 CodesN42.39

N42.39

Billable

Other dysplasia of prostate

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

Code Description

ICD-10 N42.39 is a billable code used to indicate a diagnosis of other dysplasia of prostate.

Key Diagnostic Point:

Other dysplasia of the prostate refers to abnormal growth or development of prostate cells that do not fit into the typical categories of benign prostatic hyperplasia (BPH) or prostate cancer. This condition can manifest as atypical glandular proliferation, which may be detected during histological examination of prostate tissue. Symptoms may overlap with those of BPH, including urinary frequency, urgency, and nocturia, but the underlying pathology is distinct. Dysplastic changes can be associated with chronic prostatitis or inflammation, which may further complicate the clinical picture. Diagnosis often involves a combination of clinical evaluation, imaging studies, and prostate-specific antigen (PSA) testing, which may be elevated in the presence of dysplasia. Management may vary based on the severity of symptoms and the degree of dysplastic changes observed, with options ranging from watchful waiting to more invasive urological procedures. Understanding the nuances of this condition is crucial for accurate coding and appropriate treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from benign prostatic hyperplasia (BPH)
  • Overlap with prostatitis symptoms
  • Need for histological confirmation
  • Variability in clinical presentation

Audit Risk Factors

  • Inadequate documentation of histological findings
  • Misclassification with BPH or prostatitis
  • Failure to document PSA levels
  • Lack of follow-up notes on patient management

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed pathology reports, PSA levels, and clinical notes on urinary symptoms.

Common Clinical Scenarios

Patients presenting with urinary symptoms and abnormal PSA levels requiring biopsy.

Billing Considerations

Ensure clear documentation of histological findings and differentiation from other prostate disorders.

Pathology

Documentation Requirements

Comprehensive biopsy reports detailing dysplastic changes.

Common Clinical Scenarios

Histological evaluation of prostate tissue samples.

Billing Considerations

Accurate reporting of dysplasia grade and associated findings is critical for coding.

Coding Guidelines

Inclusion Criteria

Use N42.39 When
  • According to official coding guidelines, N42
  • 39 should be used when there is clear documentation of dysplastic changes in the prostate that do not fit into other specified categories
  • It is important to ensure that the diagnosis is supported by appropriate clinical and histological documentation

Exclusion Criteria

Do NOT use N42.39 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

55700CPT Code

Prostate biopsy

Clinical Scenario

Used when a biopsy is performed to evaluate for dysplasia.

Documentation Requirements

Pathology report confirming dysplastic changes.

Specialty Considerations

Urologists must ensure accurate coding based on biopsy results.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of prostate disorders, including dysplasia. This specificity aids in better tracking of patient outcomes and treatment efficacy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of prostate disorders, including dysplasia. This specificity aids in better tracking of patient outcomes and treatment efficacy.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of prostate disorders, including dysplasia. This specificity aids in better tracking of patient outcomes and treatment efficacy.

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 is the significance of coding N42.39?

Coding N42.39 accurately reflects the diagnosis of other dysplasia of the prostate, which is crucial for appropriate patient management and treatment planning. It also helps in tracking the prevalence of this condition in clinical practice.