Benign Prostatic Hyperplasia B028
Current RMA Instruments:
| Reasonable Hypothesis SOP | 13 of 2025 |
| 14 of 2025 |
Changes from previous Instruments:
ICD Coding:
- ICD-10-AM: N40
Brief description
Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, which is located at the base of the bladder (in men only). This condition is common in older men and results in urinary symptoms.
Confirming the diagnosis
The diagnosis is made from clinical evaluation, with pathology and imaging tests generally helpful but not required for confirmation.
To establish this diagnosis, the assessment and/or management may involve consultation with a urologist.
Additional diagnoses covered by SOP
- Benign prostatic hypertrophy
- Benign enlargement of the prostate
- Prostate enlargement
Conditions not covered by SOP
- Malignant neoplasm of the prostate *
- Overactive bladder #
- Prostatitis #
* another SOP applies - the SOP has the same name unless otherwise specified
# non-SOP condition
Clinical onset
This condition involves lower urinary tract symptoms that are non-specific to benign prostatic hyperplasia. Symptoms typically appear slowly and progress gradually over a period of years. Once the diagnosis has been confirmed, clinical onset can be dated to the onset of the first clinical event or presentation that is judged by a treating doctor to be related to the condition.
Clinical worsening
The normal course of the condition is for gradual progression of the symptoms. Most men experience symptom relief with medical or surgical treatments. Not being able to obtain appropriate clinical management can lead to worsening. However, establishing clinical worsening beyond the normal course of the condition will best be assessed by a urologist.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/b/benign-prostatic-hyperplasia-b028-n40
Rulebase for benign prostatic hyperplasia
<div><h5><strong>Current RMA Instruments:</strong></h5><table border="1" cellspacing="1" cellpadding="1"><tbody><tr><td><a href="http://www.rma.gov.au/assets/SOP/2025/63971ac81b/013.pdf" target="_blank"><em>Reasonable Hypothesis SOP</em></a></td><td><span>13 of 2025</span></td></tr><tr><td><address><p><a href="http://www.rma.gov.au/assets/SOP/2025/7bf8afd8c7/014.pdf" target="_blank">Balance of Probabilities SOP</a></p></address></td><td><span>14 of 2025</span></td></tr></tbody></table><h5><strong>Changes from previous Instruments:</strong></h5><drupal-media data-entity-type="media" data-entity-uuid="ca412bce-1194-4eab-be75-48cafbb270e6"> </drupal-media><h5> </h5><h5><strong>ICD Coding:</strong></h5><ul><li>ICD-10-AM: N40</li></ul><h5><strong>Brief description</strong></h5><p>Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, which is located at the base of the bladder (in men only). This condition is common in older men and results in urinary symptoms. </p><h5><strong>Confirming the diagnosis</strong></h5><p>The diagnosis is made from clinical evaluation, with pathology and imaging tests generally helpful but not required for confirmation.</p><p>To establish this diagnosis, the assessment and/or management may involve consultation with a urologist. </p><h5><strong>Additional diagnoses covered by SOP</strong></h5><ul><li>Benign prostatic hypertrophy</li><li>Benign enlargement of the prostate</li><li>Prostate enlargement</li><li> </li></ul><h5><strong>Conditions not covered by SOP</strong></h5><ul><li>Malignant neoplasm of the prostate *</li><li>Overactive bladder #</li><li>Prostatitis #</li></ul><p>* another SOP applies - the SOP has the same name unless otherwise specified</p><p><font size="2"><sup>#</sup></font> non-SOP condition</p><h5><strong>Clinical onset</strong></h5><p>This condition involves lower urinary tract symptoms that are non-specific to benign prostatic hyperplasia. Symptoms typically appear slowly and progress gradually over a period of years. <span>Once the diagnosis has been confirmed, clinical onset can be dated to the onset of the first clinical event or presentation that is judged by a treating doctor to be related to the condition.</span></p><h5><strong>Clinical worsening</strong></h5><p>The normal course of the condition is for gradual progression of the symptoms. Most men experience symptom relief with medical or surgical treatments. Not being able to obtain appropriate clinical management can lead to worsening. However, establishing clinical worsening beyond the normal course of the condition will best be assessed by a urologist. </p></div>
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/alphabetic-index-statements-principles/b/benign-prostatic-hyperplasia-b028-n40/rulebase-benign-prostatic-hyperplasia
Inability to undertake any physical activity greater than 3 METs
Current RMA Instruments:
| Reasonable Hypothesis SOP | 13 of 2025 |
| 14 of 2025 |
Changes from previous Instruments:
ICD Coding:
- ICD-10-AM: N40
Brief description
Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, which is located at the base of the bladder (in men only). This condition is common in older men and results in urinary symptoms.
Confirming the diagnosis
The diagnosis is made from clinical evaluation, with pathology and imaging tests generally helpful but not required for confirmation.
To establish this diagnosis, the assessment and/or management may involve consultation with a urologist.
Additional diagnoses covered by SOP
- Benign prostatic hypertrophy
- Benign enlargement of the prostate
- Prostate enlargement
Conditions not covered by SOP
- Malignant neoplasm of the prostate *
- Overactive bladder #
- Prostatitis #
* another SOP applies - the SOP has the same name unless otherwise specified
# non-SOP condition
Clinical onset
This condition involves lower urinary tract symptoms that are non-specific to benign prostatic hyperplasia. Symptoms typically appear slowly and progress gradually over a period of years. Once the diagnosis has been confirmed, clinical onset can be dated to the onset of the first clinical event or presentation that is judged by a treating doctor to be related to the condition.
Clinical worsening
The normal course of the condition is for gradual progression of the symptoms. Most men experience symptom relief with medical or surgical treatments. Not being able to obtain appropriate clinical management can lead to worsening. However, establishing clinical worsening beyond the normal course of the condition will best be assessed by a urologist.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/alphabetic-index-statements-principles/b/benign-prostatic-hyperplasia-b028-n40/rulebase-benign-prostatic-hyperplasia/inability-undertake-any-physical-activity-greater-3-mets
No appropriate clinical management for benign prostatic hypertrophy
Current RMA Instruments:
| Reasonable Hypothesis SOP | 13 of 2025 |
| 14 of 2025 |
Changes from previous Instruments:
ICD Coding:
- ICD-10-AM: N40
Brief description
Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, which is located at the base of the bladder (in men only). This condition is common in older men and results in urinary symptoms.
Confirming the diagnosis
The diagnosis is made from clinical evaluation, with pathology and imaging tests generally helpful but not required for confirmation.
To establish this diagnosis, the assessment and/or management may involve consultation with a urologist.
Additional diagnoses covered by SOP
- Benign prostatic hypertrophy
- Benign enlargement of the prostate
- Prostate enlargement
Conditions not covered by SOP
- Malignant neoplasm of the prostate *
- Overactive bladder #
- Prostatitis #
* another SOP applies - the SOP has the same name unless otherwise specified
# non-SOP condition
Clinical onset
This condition involves lower urinary tract symptoms that are non-specific to benign prostatic hyperplasia. Symptoms typically appear slowly and progress gradually over a period of years. Once the diagnosis has been confirmed, clinical onset can be dated to the onset of the first clinical event or presentation that is judged by a treating doctor to be related to the condition.
Clinical worsening
The normal course of the condition is for gradual progression of the symptoms. Most men experience symptom relief with medical or surgical treatments. Not being able to obtain appropriate clinical management can lead to worsening. However, establishing clinical worsening beyond the normal course of the condition will best be assessed by a urologist.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/alphabetic-index-statements-principles/b/benign-prostatic-hyperplasia-b028-n40/rulebase-benign-prostatic-hyperplasia/no-appropriate-clinical-management-benign-prostatic-hypertrophy