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Hematospermia.com

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Hematospermia: clinician quick reference

By the Hematospermia.com editorial teamUpdated Medical review pending
Illustration of a clinician's desk with a laptop showing a flowchart, a stethoscope and a notepad.

Educational information only, not a diagnosis. Know when to get help.

On this page
  1. Coding
  2. Initial assessment
  3. Who to refer
  4. Specialist workup
  5. Management
  6. Sources

A one-page summary of published guidance for primary care clinicians, residents and coders. For patient-facing detail see the rest of the site.

Coding

ICD-10-CM R36.1 Hematospermia (billable; male-specific) [ICD-10-CM]. Synonyms: hemospermia. Code the underlying cause instead when one is established (for example prostatitis or a sexually transmitted infection), following official guidelines [CMS].

Initial assessment

  • Exclude pseudo-hematospermia (hematuria, partner bleeding) [RACGP] [MSD].
  • History: duration, recurrence, procedures (biopsy, TURP, vasectomy), sexual and travel history, anticoagulants, bleeding history, LUTS, constitutional symptoms, family history of prostate cancer [AAFP] [RACGP].
  • Exam: BP, genitalia/testes, DRE [review].
  • Tests: urinalysis ± culture; STI NAAT (first-void urine) if indicated; PSA if ≥40 years, abnormal DRE or risk factors; consider FBC/coagulation if persistent [RACGP].

Who to refer

NICE CKS: refer men over 40 with no cause found in primary care; any age with recurrent/persistent hematospermia, persistence despite treatment, suspected cysts/calculi, or features suggesting malignancy (suspected-cancer pathway) [NICE CKS]. RACGP lists concurrent hematuria and abnormal PSA or DRE as referral indications [RACGP].

Labeled schematic back view of the male reproductive tract showing the bladder, ureters, seminal vesicles, vas deferens, prostate, ejaculatory ducts, urethra, epididymis and testes.
Semen is made mostly in the seminal vesicles and prostate (highlighted). Bleeding anywhere along this pathway can tint semen. Schematic, not to scale; source: MSD Manual.

Specialist workup

TRUS, MRI, cystoscopy, scrotal ultrasound as indicated [AAFP] [MSD].

Management

Reassurance for self-limited cases with a negative workup; treat identified causes. Empiric antibiotics for presumed prostatitis are used by some but considered controversial [review]. Post-procedural hematospermia should resolve within about 3–4 weeks [NICE CKS].

Sources

  1. ICD-10-CM R36.1 Hematospermia ICD10Data.com (FY2026/2027 code set; verify against CMS/CDC files)
  2. ICD-10 codes Centers for Medicare & Medicaid Services
  3. Haematospermia Australian Family Physician (RACGP), Dec 2015
  4. Hematospermia MSD Manual Professional Edition
  5. Evaluation and Treatment of Hematospermia American Family Physician, 2009;80(12):1421-1427
  6. Hematospermia: etiology, diagnosis, and treatment Review article, PubMed Central (PMC5904639)
  7. Haematospermia: management NICE Clinical Knowledge Summaries
  8. Laboratory and clinical management of leukocytospermia and hematospermia: a review PubMed Central (PMC7290265)

We link to primary medical sources so you can check our work. See the editorial policy and the full reference list.