N41.3 ICD-10-CM Code: Prostatocystitis
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- Tabular directives
- 1 use-additional code
Inpatient Payment Groups (MS-DRG)
Potential MS-DRG participation — not a DRG assignment.
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.
- MS-DRG 727 — INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC (MDC 12)
- MS-DRG 728 — INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC (MDC 12)
A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for N41.3 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025
Notes without a marker are published on N41.3 itself; “inherited from” names the category or block whose note applies here.
Use Additional Code
Supplementary codes the tabular list directs you to add.
- Use additional code (B95-B97), to identify infectious agent.
Source: inherited from N41
Coder workflow for N41.3
MedCoder structured workflow — derived from this code’s own official record
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
- Acuity
- Acute or chronic as documented; when both are documented and separate codes exist, both are reported with the acute code first (Guidelines I.B.8).
- The conditions the Use Additional Code note names
- Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.
Official instructions as workflow
Use Additional Code — after identifying N41.3(1 note)
Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with N41.3 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.
See the official tabular notes · Guidelines I.A.13
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: A condition the Use Additional Code note names is documented.
Coding question: Is a second code reported with N41.3?
Path: Review the Use Additional Code note and the code it names.
Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Indexed Clinical Terms (3)
Official source data — entries quoted as published, in the Index’s own lookup phrasing
Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.
Verify Before Coding
- Age-restricted: the Medicare Code Editor lists this as an adult (age 15-124) diagnosis; other ages are presumed incorrect.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.
Relationships & Classification
MedCoder structured relationships — computed from published CMS and AHRQ datasets
Other codes that name N41.3 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
Referenced by 2 Excludes1 notes: N30 — Cystitis, N42.1 — Congestion and hemorrhage of prostate (via N41.-).
These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.
MS-DRG Grouper Relationships (FY2026)
Potential MS-DRG participation — not a DRG assignment.
FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.
Named in the grouper logic of 2 MS-DRGs: DRG 727 (MDC 12), DRG 728 (MDC 12).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):GEN013 — Inflammatory conditions of male genital organs (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Related Codes
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Inflammatory conditions of male genital organs).
A54.23 — Gonococcal infection of other male genital organs, A59.02 — Trichomonal prostatitis, A60.01 — Herpesviral infection of penis, A60.02 — Herpesviral infection of other male genital organs, B26.0 — Mumps orchitis, B37.42 — Candidal balanitis, B38.81 — Prostatic coccidioidomycosis, N41.0 — Acute prostatitis, N41.1 — Chronic prostatitis, N41.2 — Abscess of prostate, N41.4 — Granulomatous prostatitis, N41.8 — Other inflammatory diseases of prostate, N41.9 — Inflammatory disease of prostate, unspecified, N43.1 — Infected hydrocele, N45.1 — Epididymitis, N45.2 — Orchitis, N45.3 — Epididymo-orchitis, N45.4 — Abscess of epididymis or testis, N47.6 — Balanoposthitis, N48.1 — Balanitis, +12 more
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Cystitis”; these codes share that main term but sit in a different category of the Tabular List.
A59.03 — Trichomonal cystitis and urethritis (trichomonal), B65.9 — Schistosomiasis, unspecified (bilharzial), B67.39 — Echinococcus granulosus infection, other sites (echinococcal, granulosus), B67.69 — Echinococcus multilocularis infection, other sites (echinococcal, multilocularis), N21.0 — Calculus in bladder (calculous), N30.00 — Acute cystitis without hematuria (acute), N30.01 — Acute cystitis with hematuria (acute, with hematuria), N30.10 — Interstitial cystitis (chronic) without hematuria (chronic, interstitial), N30.11 — Interstitial cystitis (chronic) with hematuria (chronic, interstitial, with hematuria), N30.20 — Other chronic cystitis without hematuria (chronic), N30.21 — Other chronic cystitis with hematuria (chronic, with hematuria), N30.30 — Trigonitis without hematuria (of trigone), N30.31 — Trigonitis with hematuria (of trigone, with hematuria), N30.40 — Irradiation cystitis without hematuria (irradiation), N30.41 — Irradiation cystitis with hematuria (irradiation, with hematuria), N30.80 — Other cystitis without hematuria (specified type NEC), N30.81 — Other cystitis with hematuria (specified type NEC, with hematuria), N30.90 — Cystitis, unspecified without hematuria, N30.91 — Cystitis, unspecified with hematuria (with, hematuria), O86.22 — Infection of bladder following delivery (puerperal), +6 more
Contextual Map
Every relationship of N41.3 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Run N41.3 with these 2 related codes in Claim Check
Hierarchy
- N00-N99 — Chapter 14: Diseases of the Genitourinary System (N00-N99) (N00-N99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- N40-N53 — Diseases of male genital organs[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Referenced by Excludes1 notes
- N30 — Cystitis[Excludes1]: “prostatocystitis (N41.3)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- N42.1 — Congestion and hemorrhage of prostate[Excludes1](via N41.-): “inflammatory diseases of prostate (N41.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Clinical classification (CCSR)
- GEN013 — Inflammatory conditions of male genital organs[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
MS-DRG Grouper
- DRG 727 — INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC[MS-DRG]: “INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC (MDC 12)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
- DRG 728 — INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC[MS-DRG]: “INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC (MDC 12)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
MDC crossing
- MDC 12 — Diseases and Disorders of the Male Reproductive System[MDC crossing]: “Diseases and Disorders of the Male Reproductive System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,964 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
Index entries
- Cystitis (exudative) (hemorrhagic) (septic) (suppurative), prostatic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Cystitis (exudative) (hemorrhagic) (septic) (suppurative), with, prostatitis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Prostatocystitis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Nearest codes
- N41 — Inflammatory diseases of prostate[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- N41.0 — Acute prostatitis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- N41.1 — Chronic prostatitis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- N41.2 — Abscess of prostate[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- N41.4 — Granulomatous prostatitis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- N41.8 — Other inflammatory diseases of prostate[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- N41.9 — Inflammatory disease of prostate, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
- Inpatient payment groups Official source data
- CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "N41.3 — Prostatocystitis." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/n41.3-prostatocystitis
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionProstatocystitis
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to N41.3 in its code family, with their registry titles.