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Compare/N43 vs P83.5

N43 vs P83.5

N43 (Hydrocele and spermatocele) compared with P83.5 (Congenital hydrocele), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. N43 carries an Excludes1 note covering P83.5: “congenital hydrocele (P83.5)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

N43Hydrocele and spermatoceleP83.5Congenital hydrocele
Billing statusNon-billable header

Report instead: N43.0, N43.1, N43.2, N43.3, N43.40

Billable
ClassificationN00-N99 — Diseases of the Genitourinary System (N00-N99)P00-P96 — Certain Conditions Originating in the Perinatal Period (P00-P96)
DefinitionHydrocele and spermatocele is a non-billable ICD-10-CM category code (N43).Congenital hydrocele is a billable ICD-10-CM diagnosis code (P83.5).
Includes
hydrocele of spermatic cord, testis or tunica vaginalis

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources