Pathology/Lab Coding Alert

Cyst moves to different family.

When you start getting test orders under ICD-10 with enlarged prostate as the ordering diagnosis, you can say goodbye to benign prostatic hypertrophy (BPH). That's because the new code set streamlines enlarged prostate coding by collapsing eight codes into four.

Although CMS has postponed the ICD-10 implementation date from Oct. 1, 2013, your lab should continue to prepare for the eventual change, now unofficially anticipated for Oct. 1, 2014.

Make 'Hypertrophy' Simple

BPH (600.0x, Hypertrophy [benign] of prostate) may be the ordering diagnosis when your lab performs a prostate specific antigen (PSA) test 84153 (Prostate specific antigen [PSA]; total) or perhaps a prostate biopsy (such as 88305, Level IV - Surgical pathology, gross and microscopic examination; prostate, needle biopsy).

But you won't see the term 'BPH' once ICD-10 goes into effect, because the new code set collapses ICD-9 terminology "hypertrophy (benign) of prostate," "benign localized hyperplasia of prostate," and "hyperplasia of prostate, unspecified" into a single terminology: "enlarged prostate."

Here's how the codes stack up:

The following three ICD-9 codes crosswalk to N40.0 (Enlarged prostate without lower urinary tract symptoms) in ICD-10:

• 600.00 -- Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptoms (luts)
• 600.20 -- Benign localized hyperplasia of prostate without urinary obstruction and other lower urinary tract symptoms (luts)
• 600.90 -- Hyperplasia of prostate, unspecified, without urinary obstruction and other lower urinary symptoms (luts)

Similarly, N40.1 (Enlarged prostate with lower urinary tract symptoms) replaces these three ICD-9 codes:

• 600.01 -- Hypertrophy (benign) of prostate with urinary obstruction and other lower urinary tract symptoms (luts)
• 600.21 -- Benign localized hyperplasia of prostate with urinary obstruction and other lower urinary tract symptoms (luts)
• 600.91 -- Hyperplasia of prostate, unspecified, with urinary obstruction and other lower urinary symptoms (luts)

Expect One-to-One for Nodular Prostate

In the same ICD-10 code family, you'll find the following direct crosswalks:

• 600.10 (Nodular prostate without urinary obstruction) changes to N40.2 (Nodular prostate without lower urinary tract symptoms)
• 600.11 (Nodular prostate with urinary obstruction) changes to N40.3 (Nodular prostate with lower urinary tract symptoms)

Prostate cyst moves out of the "enlarged prostate" code family to the "other and unspecified disorders of prostate" code family in ICD-10. You'll see 600.3 (Cyst of prostate) change to N42.83 (Cyst of prostate) when the new codes go into effect.