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ICD-10 Guide
ICD-10 CodesN52.01

N52.01

Billable

Erectile dysfunction due to arterial insufficiency

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

Code Description

ICD-10 N52.01 is a billable code used to indicate a diagnosis of erectile dysfunction due to arterial insufficiency.

Key Diagnostic Point:

Erectile dysfunction (ED) due to arterial insufficiency is a condition characterized by the inability to achieve or maintain an erection sufficient for satisfactory sexual performance, specifically resulting from inadequate blood flow to the penis. This insufficiency is often caused by atherosclerosis, where plaque builds up in the arteries, leading to reduced blood supply. Risk factors include age, diabetes, hypertension, smoking, and hyperlipidemia. Clinically, patients may present with a gradual onset of erectile difficulties, often accompanied by other signs of vascular disease. Diagnosis typically involves a thorough medical history, physical examination, and may include vascular studies to assess blood flow. Treatment options may include lifestyle modifications, pharmacotherapy (such as phosphodiesterase type 5 inhibitors), and in some cases, surgical interventions to improve arterial blood flow. Understanding the underlying vascular causes is crucial for effective management and improving sexual health outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various causes of erectile dysfunction.
  • Need for comprehensive patient history to establish arterial insufficiency.
  • Potential overlap with other erectile dysfunction codes.
  • Documentation of comorbid conditions affecting vascular health.

Audit Risk Factors

  • Inadequate documentation of arterial insufficiency.
  • Failure to document comorbid conditions.
  • Lack of evidence for the diagnosis of erectile dysfunction.
  • Misclassification of erectile dysfunction due to other causes.

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed patient history, physical examination findings, and any diagnostic tests performed.

Common Clinical Scenarios

Patients presenting with erectile dysfunction, especially those with known vascular risk factors.

Billing Considerations

Urologists should ensure that all relevant vascular assessments are documented to support the diagnosis.

Endocrinology

Documentation Requirements

Assessment of hormonal levels, particularly testosterone, and documentation of any metabolic syndrome components.

Common Clinical Scenarios

Patients with diabetes or metabolic syndrome presenting with erectile dysfunction.

Billing Considerations

Endocrinologists should document the relationship between hormonal imbalances and erectile dysfunction.

Coding Guidelines

Inclusion Criteria

Use N52.01 When
  • According to ICD
  • 10 guidelines, N52
  • 01 should be used when erectile dysfunction is specifically attributed to arterial insufficiency
  • Coders must ensure that the documentation supports this diagnosis and that other potential causes are ruled out

Exclusion Criteria

Do NOT use N52.01 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

CPT 54160CPT Code

Penile prosthesis implantation

Clinical Scenario

Used in cases where conservative treatments fail due to arterial insufficiency.

Documentation Requirements

Detailed documentation of previous treatments and their outcomes.

Specialty Considerations

Urologists should 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, including the ability to identify underlying causes such as arterial insufficiency. This specificity improves data accuracy and enhances the understanding of the condition's prevalence and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of erectile dysfunction, including the ability to identify underlying causes such as arterial insufficiency. This specificity improves data accuracy and enhances the understanding of the condition's prevalence and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of erectile dysfunction, including the ability to identify underlying causes such as arterial insufficiency. This specificity improves data accuracy and enhances the understanding of the condition's prevalence and treatment outcomes.

Resources

Clinical References

  • •
    American Urological Association Guidelines

Coding & Billing References

  • •
    American Urological Association Guidelines

Frequently Asked Questions

What is the primary cause of erectile dysfunction in patients with arterial insufficiency?

The primary cause is reduced blood flow to the penis due to narrowed or blocked arteries, often resulting from atherosclerosis or other vascular diseases.