ICD-10 · PDGM grouping
N40 Benign prostatic hyperplasia
All 4 codes in the N40 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
4
Can lead a claim
4
Cannot lead a claim
0
What CMS assigns to N40
All 4 codes group to MMTA - Gastrointestinal tract and Genitourinary system. 1 of the 4 counts toward the Other disorders of the kidney and ureter, excluding chronic kidney disease and ESRD comorbidity subgroup; 3 are assigned none. Every code can lead a claim.
- Other disorders of the kidney and ureter, excluding chronic kidney disease and ESRD: counts toward the high comorbidity tier only in an interaction pair.
Every code in N40
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| N40.0 | Benign prostatic hyperplasia without lower urinary tract symptomsCMS: Benign prostatic hyperplasia without lower urinry tract symp | Can lead a claim | J | None |
| N40.1 | Benign prostatic hyperplasia with lower urinary tract symptomsCMS: Benign prostatic hyperplasia with lower urinary tract symp | Can lead a claim | J | Other disorders of the kidney and ureter, excluding chronic kidney disease and ESRD |
| N40.2 | Nodular prostate without lower urinary tract symptoms | Can lead a claim | J | None |
| N40.3 | Nodular prostate with lower urinary tract symptoms | Can lead a claim | J | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
The monthly home health regs digest
What CMS changed, what's due next, and what to do about it — one email a month, no fluff. Read the first issue