N40.1: Benign prostatic hyperplasia with lower urinary tract symptoms

N40.1, benign prostatic hyperplasia with lower urinary tract symptoms, is listed as a covered diagnosis in 9 Medicare billing and coding articles that apply to 2 HCPCS Level II codes, including C2596 (Probe, image-guided, robotic, waterjet ablation), G0278 (Iliac and/or femoral artery angiography, non-selective…). The articles come from 7 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with N40.1 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
C2596Probe, image-guided, robotic, waterjet ablationSpecial coverage instructions apply—7
G0278Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure)Carrier judgment—2

Medicare policy articles listing N40.1

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Frequently asked questions

Does Medicare cover N40.1 (Benign prostatic hyperplasia with lower urinary tract…)?

Medicare covers items and services, not diagnoses. 9 Medicare billing and coding articles list N40.1 as a covered diagnosis for 2 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 N40.1?

The Level II codes from the policies most specific to this diagnosis are C2596 (Probe, image-guided, robotic, waterjet ablation, 7 articles); G0278 (Iliac and/or femoral artery angiography, non-selective…, 2 articles). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list N40.1?

A56797 (Billing and Coding: Fluid Jet System Treatment for LUTs/BPH); A57926 (Billing and Coding: Fluid Jet System in the Treatment of Benign Prostatic Hyperplasia (BPH)); A58008 (Billing and Coding: Transurethral Waterjet Ablation of the Prostate), and 6 more articles.

What is ICD-10-CM code N40.1?

N40.1 is the ICD-10-CM code for benign prostatic hyperplasia with lower urinary tract symptoms, in category N40 (Benign prostatic hyperplasia), chapter 14: Diseases of the genitourinary system.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

Chapter 14: Diseases of the genitourinary system · All diagnoses · HCPCS lookup