N34.3 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

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Code lookupN34.3

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the genitourinary system (N00-N99) / Other diseases of the urinary system (N30-N39)

N34.3

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Urethral syndrome, unspecified

A collection of urethral symptoms such as dysuria, urinary frequency, and urgency without a clearly identified underlying cause.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

N34Urethritis and urethral syndrome N34.3Urethral syndrome, unspecified

Inclusion Terms

Official

No inclusion terms are included in this display for N34.3. Check the code and parent instructions in the Code Book.

Excludes 2

Official

certain conditions originating in the perinatal period (P04-P96)Inherited from N00-N99, N30-N39, N34
certain infectious and parasitic diseases (A00-B99)Inherited from N00-N99, N30-N39, N34
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from N00-N99, N30-N39, N34
congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from N00-N99, N30-N39, N34
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from N00-N99, N30-N39, N34
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from N00-N99, N30-N39, N34
neoplasms (C00-D49)Inherited from N00-N99, N30-N39, N34
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from N00-N99, N30-N39, N34
urinary infection (complicating):Inherited from N00-N99, N30-N39, N34
abortion or ectopic or molar pregnancy (O00-O07, O08.8)Inherited from N00-N99, N30-N39, N34
pregnancy, childbirth and the puerperium (O23.-, O75.3, O86.2-)Inherited from N00-N99, N30-N39, N34
Reiter's disease (M02.3-)Inherited from N00-N99, N30-N39, N34
urethritis in diseases with a predominantly sexual mode of transmission (A50-A64)Inherited from N00-N99, N30-N39, N34
urethrotrigonitis (N30.3-)Inherited from N00-N99, N30-N39, N34

Related Codes

Official

N34.0Urethral abscess N34.1Nonspecific urethritis N34.2Other urethritis

Includes

Official

No Includes notes are included in this display for N34.3. Check the code and parent instructions in the Code Book.

Excludes 1

Official

No Excludes 1 notes are included in this display for N34.3. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for N34.3. Check the code and parent instructions in the Code Book.

Use Additional

Official

code (B95-B97), to identify infectious agent.Inherited from N34

Code Also

Official

No Code Also instructions are included in this display for N34.3. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

This is a diagnosis of exclusion; ensure that other specific urethral conditions have been ruled out before assigning this code

Document all presenting symptoms to support the diagnosis and guide further diagnostic workup

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is N34.3 an HCC code?

No. N34.3 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code: N34.3
Description: Urethral syndrome, unspecified
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

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What This Code Means

N34.3 is the ICD-10-CM diagnosis code for urethral syndrome, unspecified. A collection of urethral symptoms such as dysuria, urinary frequency, and urgency without a clearly identified underlying cause. N34.3 sits in the ICD-10-CM chapter for diseases of the genitourinary system (n00-n99), within the section covering other diseases of the urinary system (n30-n39).

N34.3 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

This is a diagnosis of exclusion; ensure that other specific urethral conditions have been ruled out before assigning this code.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for N34.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This is a diagnosis of exclusion; ensure that other specific urethral conditions have been ruled out before assigning this code
•Document all presenting symptoms to support the diagnosis and guide further diagnostic workup