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v1.0.0
ICD-10 Guide
ICD-10 CodesN49.1

N49.1

Billable

Inflammatory disorders of spermatic cord, tunica vaginalis and vas deferens

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

Code Description

ICD-10 N49.1 is a billable code used to indicate a diagnosis of inflammatory disorders of spermatic cord, tunica vaginalis and vas deferens.

Key Diagnostic Point:

N49.1 encompasses a range of inflammatory conditions affecting the spermatic cord, tunica vaginalis, and vas deferens, which are critical components of the male reproductive system. These disorders can manifest as hydrocele, orchitis, or epididymitis, leading to symptoms such as scrotal swelling, pain, and potential male infertility. Hydrocele, characterized by the accumulation of fluid in the tunica vaginalis, may arise from inflammation or infection. Orchitis, an inflammation of the testis, can be viral or bacterial in origin and may present with acute pain and swelling. Inflammatory disorders can also impact the vas deferens, potentially leading to obstruction and subsequent infertility. Accurate diagnosis often requires imaging studies and laboratory tests to identify underlying infections or inflammatory processes. Management may involve antibiotics for infections, surgical intervention for hydrocele, or other andrological treatments to address infertility. Understanding these conditions is essential for proper coding and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes (infectious, non-infectious)
  • Overlap with other urological conditions
  • Need for detailed clinical documentation
  • Potential for co-morbid conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to specify the type of inflammatory disorder
  • Misclassification of related conditions
  • Lack of follow-up documentation for treatment outcomes

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed clinical notes including symptoms, diagnostic tests, and treatment plans.

Common Clinical Scenarios

Patients presenting with scrotal pain, swelling, or infertility.

Billing Considerations

Ensure clear documentation of the inflammatory process and any associated conditions.

Andrology

Documentation Requirements

Comprehensive assessment of male reproductive health, including fertility evaluations.

Common Clinical Scenarios

Men seeking evaluation for infertility or recurrent infections.

Billing Considerations

Document any interventions aimed at improving fertility outcomes.

Coding Guidelines

Inclusion Criteria

Use N49.1 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the inflammatory nature of the condition
  • Include any relevant laboratory or imaging results that support the diagnosis

Exclusion Criteria

Do NOT use N49.1 When
  • Exclude conditions that do not meet the criteria for inflammatory disorders

Related ICD-10 Codes

Related CPT Codes

54500CPT Code

Excision of hydrocele

Clinical Scenario

Used when surgical intervention is required for hydrocele associated with inflammation.

Documentation Requirements

Document the indication for surgery and any pre-operative evaluations.

Specialty Considerations

Urologists should ensure clear documentation of the inflammatory nature of the hydrocele.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of inflammatory disorders, improving the accuracy of diagnoses and treatment planning. N49.1 provides a clear framework for identifying and managing these conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of inflammatory disorders, improving the accuracy of diagnoses and treatment planning. N49.1 provides a clear framework for identifying and managing these conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of inflammatory disorders, improving the accuracy of diagnoses and treatment planning. N49.1 provides a clear framework for identifying and managing these conditions.

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 causes of inflammatory disorders of the spermatic cord?

Common causes include infections (bacterial or viral), trauma, and autoimmune conditions. Conditions like orchitis and epididymitis are frequently associated with these inflammatory disorders.