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ICD-10 Guide
ICD-10 CodesN44.04

N44.04

Billable

Torsion of appendix epididymis

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

Code Description

ICD-10 N44.04 is a billable code used to indicate a diagnosis of torsion of appendix epididymis.

Key Diagnostic Point:

Torsion of the appendix epididymis is a condition characterized by the twisting of the small appendage located on the epididymis, which can lead to ischemia and pain. This condition is often seen in adolescents and young adults, presenting with sudden onset scrotal pain, swelling, and tenderness. The appendix epididymis is a remnant of the mesonephric duct and is typically asymptomatic; however, when torsion occurs, it can mimic other acute scrotal conditions such as testicular torsion or epididymitis. Diagnosis is primarily clinical, supported by imaging studies such as Doppler ultrasound to assess blood flow. Treatment usually involves surgical intervention to untwist the appendage and may include excision if necrosis is present. Complications can include chronic pain or infertility if not treated promptly. Understanding this condition is crucial for differentiating it from other testicular disorders, as timely intervention can prevent severe outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from testicular torsion and epididymitis
  • Need for imaging studies to confirm diagnosis
  • Potential for surgical intervention and associated coding
  • Variability in presentation among different age groups

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to document imaging results
  • Misdiagnosis leading to incorrect coding
  • Lack of surgical documentation if applicable

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed clinical notes including onset, duration, and severity of symptoms, as well as imaging results.

Common Clinical Scenarios

Acute scrotal pain in adolescents, differential diagnosis of scrotal masses.

Billing Considerations

Ensure clear documentation of the surgical procedure performed and any findings.

Emergency Medicine

Documentation Requirements

Thorough assessment notes, including vital signs and pain assessment.

Common Clinical Scenarios

Patients presenting with acute scrotal pain requiring immediate evaluation.

Billing Considerations

Document all interventions and consultations with urology.

Coding Guidelines

Inclusion Criteria

Use N44.04 When
  • Follow official ICD
  • CM guidelines for coding conditions related to the male reproductive system
  • Ensure accurate documentation of the clinical scenario and any imaging studies performed
  • Include any relevant history of similar conditions

Exclusion Criteria

Do NOT use N44.04 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

54840CPT Code

Exploration of scrotum

Clinical Scenario

Used when surgical intervention is required for torsion.

Documentation Requirements

Document findings during exploration and any procedures performed.

Specialty Considerations

Urologists should ensure detailed operative notes are available.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like torsion of the appendix epididymis, improving data accuracy and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like torsion of the appendix epididymis, improving data accuracy and facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like torsion of the appendix epididymis, improving data accuracy and facilitating better patient management.

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 are the common symptoms of torsion of the appendix epididymis?

Common symptoms include sudden onset of scrotal pain, swelling, and tenderness, often accompanied by nausea or vomiting.

How is torsion of the appendix epididymis diagnosed?

Diagnosis is primarily clinical, supported by imaging studies such as Doppler ultrasound to assess blood flow to the affected area.

What is the treatment for torsion of the appendix epididymis?

Treatment typically involves surgical intervention to untwist the appendage and may include excision if necrosis is present.