ICD-10 N40.1
Billable / SpecificBenign prostatic hyperplasia with lower urinary tract symptoms
About ICD-10-CM N40.1
ICD-10-CM code N40.1 represents Benign prostatic hyperplasia with lower urinary tract symptoms. This is a billable/specific code in the Genitourinary System chapter (block N40). The 2026 edition of ICD-10-CM N40.1 became effective on October 1, 2025.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under N40.1. Per CMS ICD-10-CM Tabular 2026.
- Enlarged prostate with LUTS
Use Additional Code
When coding N40.1, also report these additional codes when applicable.
- code for associated symptoms, when specified:
- incomplete bladder emptying (R39.14)
- nocturia (R35.1)
- straining on urination (R39.16)
- urinary frequency (R35.0)
- urinary hesitancy (R39.11)
- urinary incontinence (N39.4-)
- urinary obstruction (N13.8)
- urinary retention (R33.8)
- urinary urgency (R39.15)
- weak urinary stream (R39.12)
Medicare LCD Coverage for N40.1
Local Coverage Determinations (LCDs) from CMS MACs that list N40.1 as a covered diagnosis.
Showing top 10 of 166 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing N40.1.
1 Aetna
5 Medicare
CPT Codes Commonly Billed with N40.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 52000 Cystoscopy — hematuria, cystitis, bladder outlet obstruction, BPH Urology
- 52000 Cystoscopy diagnostic — bladder neck obstruction, cystitis, hematuria, hydronephrosis, bladder cancer, BPH, urinary retention, urethral stricture, poor stream, bladder calculus Urology
- 52601 TURP — BPH with LUTS, BPH, urinary retention, poor stream, hydronephrosis, bladder neck obstruction, hematuria Urology
- 76857 Pelvic ultrasound non-OB — BPH, urinary retention, hematuria, poor stream, hydronephrosis, bladder cancer, pelvic pain, cystitis Urology
- C2596 CMS LCD: Billing and Coding: Transurethral Waterjet Ablation of the Prostate CMS LCD
- 0421T CMS LCD: Billing and Coding: Transurethral Waterjet Ablation of the Prostate CMS LCD
- 52649 CMS LCD: Billing and Coding: Laser Ablation of the Prostate CMS LCD
- 52648 CMS LCD: Billing and Coding: Laser Ablation of the Prostate CMS LCD
- 52597 CMS LCD: Billing and Coding: Transurethral Waterjet Ablation of the Prostate CMS LCD
Convert N40.1 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| N40.1 | 60001 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To N40.1
Other codes in section N40-N53 (Diseases of male genital organs).
ICD-10 N40.1, Billing FAQ
Is ICD-10 code N40.1 billable? +
Yes, N40.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to N40.1? +
ICD-10 N40.1 includes: Enlarged prostate with LUTS.
What CPT codes are commonly billed with N40.1? +
Procedures frequently paired with N40.1 include: 52000, 52000, 52601, 76857, C2596.
What ICD-9 codes does N40.1 map to? +
Per CMS GEMs, N40.1 maps to ICD-9 codes: 60001. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on July 16, 2026.
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