N35.813
BillableOther membranous urethral stricture, male
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is N35.813 an HCC code?
No. N35.813 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
N35.813 is the ICD-10-CM diagnosis code for other membranous urethral stricture, male. A narrowing of the membranous portion of the male urethra (the section passing through the prostate) from causes other than infection. N35.813 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).
N35.813 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Membranous stricture location must be clearly documented in the medical record.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for N35.813 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Membranous stricture location must be clearly documented in the medical record
- •This code is specific to males; verify gender documentation