Erectile Dysfunction ICD-10 Code (N52.9) and What Insurers Ask For

An ICD-10 code is the short label a clinician puts on your chart and on any insurance claim. ICD-10-CM is the US version used for diagnoses. You never need to pick one yourself. But knowing the codes helps you read a claim, an insurer's policy, or a denial letter.

Erectile dysfunction ICD-10 codes, in full

Here is every code in the N52 group, with the official title, read from the National Library of Medicine's ICD-10-CM search on 14 November 2026.

Source: NLM Clinical Tables, ICD-10-CM search for N52, read 14 November 2026.

Several N52.3 codes describe ED after prostate surgery or radiation, covered in our ED and prostate cancer guide.

Erectile dysfunction ICD 10: the codes outside N52

Two other codes come up often. When the cause is mental, not physical, the code is F52.21, "Male erectile disorder" (NLM Clinical Tables: F52.21, read 14 November 2026). Aetna's policy labels this code "psychogenic impotence", meaning ED that starts in the mind.

The second is a prostate code. Tadalafil, the drug in Cialis, is also approved for an enlarged prostate. The code for that is N40.1, "Benign prostatic hyperplasia with lower urinary tract symptoms" (NLM Clinical Tables: N40, read 14 November 2026). Lower urinary tract symptoms means trouble peeing, such as a weak stream. A tadalafil fill for this code is a different coverage question from a fill for ED.

Who keeps the codes, and when they change

The codes are updated each year. CMS, the federal agency that runs Medicare, posts the yearly files. Its ICD-10 page says: "CDC announces new ICD-10-CM codes effective October 1, 2026." (CMS: ICD-10 codes, read 14 November 2026). The N52 codes above are the ones listed in the current search on that date.

What insurers ask for

The code is only the first step. What a plan asks for depends on the type of plan and on what you want covered.

Medicare Part D. Federal law bars Part D from covering drugs "used for the treatment of sexual or erectile dysfunction" (42 U.S.C. 1395w-102, read 14 November 2026). An ED code on a Part D claim for sildenafil will not help. The law looks at what the drug is used for.

Employer and marketplace plans. These are not bound by the Part D rule, so it depends on the plan. Aetna's policy on ED gives a clear example. It says: "Many Aetna pharmacy benefit plans exclude coverage of drugs for lifestyle enhancement or performance." It adds that under these plans, Viagra, Levitra and Cialis "are covered only when required by state regulation or when a plan sponsor has elected an optional rider under the pharmacy plan" (Aetna clinical policy bulletin 0007, read 14 November 2026). A rider is an add-on the employer chooses to buy. Our Aetna ED coverage guide has the rest of that policy.

Medical treatments, not pills. The same Aetna policy lists codes it covers "if selection criteria are met". Among them are "N52.01 - N52.1, N52.31 - N52.39" for ED with a physical cause. It lists F52.21, N52.2 and "N52.8 - N52.9" under codes it does not cover for the treatments in that policy (Aetna clinical policy bulletin 0007). So for things like vacuum pumps or implants, a specific physical-cause code can matter more than N52.9.

Prior authorization, in plain words

Prior authorization (often called prior auth) means the plan must say yes before it pays. For ED drugs, a plan that covers them may ask the prescriber to show:

• the diagnosis, with its ICD-10 code;
• that other causes were checked;
• that a generic was tried first, where the plan has a generic rule;
• that the number of tablets fits the plan's monthly limit.

Not every plan asks for all of these. Each plan sets its own rules. Your plan's formulary, the list of covered drugs, says which apply. Search it for "sildenafil" and "tadalafil".

When cash beats the code

For most men, the cheapest route skips insurance. Generic sildenafil and tadalafil are cheap with a prescription. Cost Plus Drugs lists generic tadalafil 5 mg tablets at $0.20 each and generic sildenafil 20 mg tablets at $0.22 each, before shipping (read 7 November and 31 October 2026).

Online programs include the visit. The lowest all-in ED plan we track is Strut Health at $16 a month. Most online programs do not take insurance at all, so the code on their chart does not change your price. Our guide to ED medication and insurance covers each type of plan in more detail.

If you do want to use insurance, ask your own doctor to send the prescription to an in-network pharmacy. Then compare the copay with the cash price before you pay.

See ED cost by program for every published price, and our best ED programs for the ranking.