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N40 ICD-10-CM Code: Benign prostatic hyperplasia

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FY 2026 Apr update / Diseases of the genitourinary system (N00-N99) / Diseases of male genital organs (N40-N53)

N40

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Benign prostatic hyperplasia

Benign prostatic hyperplasia

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
N4Diseases of male genital organs (N40-N53)
N40Benign prostatic hyperplasia

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for N40 in this effective period.

Excludes 2

Official
  • malignant neoplasm of prostate (C61)

Related Child Codes

Official
N40.0Benign prostatic hyperplasia without lower urinary tract symptoms
N40.1Benign prostatic hyperplasia with lower urinary tract symptoms
N40.2Nodular prostate without lower urinary tract symptoms
N40.3Nodular prostate with lower urinary tract symptoms

Includes

Official
  • adenofibromatous hypertrophy of prostate
  • benign hypertrophy of the prostate
  • benign prostatic hypertrophy
  • BPH
  • enlarged prostate

Excludes 1

Official
  • benign neoplasms of prostate (adenoma, benign) (fibroadenoma) (fibroma) (myoma) (D29.1)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for N40 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for N40 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for N40 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

N40 is the ICD-10-CM diagnosis code for benign prostatic hyperplasia. N40 sits in the ICD-10-CM chapter for diseases of the genitourinary system (n00-n99), within the section covering diseases of male genital organs (n40-n53).

Header codes like N40 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at N40's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for N40 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • adenofibromatous hypertrophy of prostate
  • benign hypertrophy of the prostate
  • benign prostatic hypertrophy
  • BPH
  • enlarged prostate
  • nodular prostate
  • polyp of prostate

Excludes 1, Do NOT code together

  • benign neoplasms of prostate (adenoma, benign) (fibroadenoma) (fibroma) (myoma) (D29.1)

Excludes 2, Not included here, may code separately

  • malignant neoplasm of prostate (C61)

Child Codes

Code Hierarchy

N40Benign prostatic hyperplasia
N40Benign prostatic hyperplasia

Work N40 in HCC Buddy

Open N40 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 14 days to try everything.