ICD-10 N42.0
Billable / SpecificCalculus of prostate
About ICD-10-CM N42.0
ICD-10-CM code N42.0 represents Calculus of prostate. This is a billable/specific code in the Genitourinary System chapter (block N42). The 2026 edition of ICD-10-CM N42.0 became effective on October 1, 2025.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under N42.0. Per CMS ICD-10-CM Tabular 2026.
- Prostatic stone
Medicare LCD Coverage for N42.0
Local Coverage Determinations (LCDs) from CMS MACs that list N42.0 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing N42.0.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but N42.0 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with N42.0
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert N42.0 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 |
|---|---|---|
| N42.0 | 6020 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To N42.0
Other codes in section N40-N53 (Diseases of male genital organs).
ICD-10 N42.0, Billing FAQ
Is ICD-10 code N42.0 billable? +
Yes, N42.0 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 N42.0? +
ICD-10 N42.0 includes: Prostatic stone.
What ICD-9 codes does N42.0 map to? +
Per CMS GEMs, N42.0 maps to ICD-9 codes: 6020. Useful for legacy data review and historical claim analysis.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team