What is the ICD-10 code for a breast abscess?

The ICD-10 code for a non-puerperal breast abscess is N61.1, while O91.13 is used for lactational breast abscesses.

How do you code a lactational breast abscess?

For a lactational breast abscess, use ICD-10 code O91.13, and include additional codes for cellulitis and postpartum care if applicable.

ICD-10 Coding for Breast Abscess(N61.1, L03.3, O91.1)

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Comprehensive guide on ICD-10 coding for breast abscesses, including lactational and non-puerperal cases. Learn about documentation requirements and coding pitfalls.

Also known as:

Mammary AbscessLactational AbscessPuerperal Breast Abscess

Related ICD-10 Code Ranges

Complete code families applicable to Breast Abscess

N00-N99Primary Range

Diseases of the genitourinary system

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Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

Code	Description	When to Use	Key Documentation
N61.1	Abscess of breast and nipple	Use for breast abscesses not associated with pregnancy or lactation.	Ultrasound confirmation of abscess Clinical documentation of non-lactational context
O91.13	Abscess of breast associated with lactation	Use for abscesses occurring during lactation or postpartum.	Documentation of lactation or postpartum status Ultrasound or clinical confirmation of abscess

Primary ICD-10-CM Codes

Abscess of the breast and nipple

N61.1Billable

Differential Codes

Alternative codes to consider when ruling out similar conditions

Abscess of breast associated with lactationO91.13

Use when the abscess is related to breastfeeding or occurs postpartum.

Abscess of breast and nippleN61.1

Use when the abscess is not related to lactation.

Documentation & Coding Risks

Avoid these common issues when documenting Breast Abscess.

Omitting lactational context in documentation

Impact

Clinical: Misrepresentation of patient condition., Regulatory: Potential for audit discrepancies., Financial: Incorrect reimbursement due to coding errors.

Mitigation

Use structured templates for documentation., Verify lactation status during patient intake.

Incorrectly coding lactational abscess as non-puerperal

Impact

Reimbursement: May result in incorrect DRG assignment and reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation

Verify lactational context in documentation before coding.

Coding accuracy for lactational abscesses

Impact

High risk of incorrect coding due to omission of lactational context.

Mitigation

Implement regular audits and training on documentation requirements.

Frequently Asked Questions

Documentation requirements, coding pitfalls and FAQs for conditions coded with N61.1.

Mastitis→

Primary Code

N61.1

Abscess of the breast and nipple

Quick Navigation

ICD-10 codes5

Coding risks3

FAQs2

ICD-10 Coding for Breast Abscess(N61.1, L03.3, O91.1)

Documentation & Coding Risks

Frequently Asked Questions

What is the ICD-10 code for a breast abscess?

How do you code a lactational breast abscess?

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