ICD-10 · PDGM grouping
N42 Other and unspecified disorders of prostate
All 11 codes in the N42 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
11
Can lead a claim
10
Cannot lead a claim
1
What CMS assigns to N42
10 of the 11 codes group to MMTA - Other (5) and MMTA - Gastrointestinal tract and Genitourinary system (5); 1 is assigned no clinical group. None of the 11 is assigned a comorbidity subgroup. 10 of the 11 can lead a claim.
Every code in N42
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 |
|---|---|---|---|---|
| N42.0 | Calculus of prostate | Can lead a claim | J | None |
| N42.1 | Congestion and hemorrhage of prostate | Can lead a claim | J | None |
| N42.3 Dysplasia of prostate | ||||
| N42.30 | Unspecified dysplasia of prostate | Can lead a claim | A | None |
| N42.31 | Prostatic intraepithelial neoplasia | Can lead a claim | J | None |
| N42.32 | Atypical small acinar proliferation of prostate | Can lead a claim | A | None |
| N42.39 | Other dysplasia of prostate | Can lead a claim | A | None |
| N42.8 Other specified disorders of prostate | ||||
| N42.81 | Prostatodynia syndrome | Can lead a claim | A | None |
| N42.82 | Prostatosis syndrome | Can lead a claim | A | None |
| N42.83 | Cyst of prostate | Can lead a claim | J | None |
| N42.89 | Other specified disorders of prostate | Can lead a claim | J | None |
| N42.9 | Disorder of prostate, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | 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.
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