Disorders of breast
ICD-10 Codes (50)
N61N61.0N61.1N61.2N61.20N61.21N61.22N61.23N62N63N63.0N63.1N63.10N63.11N63.12N63.13N63.14N63.15N63.2N63.20N63.21N63.22N63.23N63.24N63.25N63.3N63.31N63.32N63.4N63.41N63.42N64N64.0N64.1N64.2N64.3N64.4N64.5N64.51N64.52N64.53N64.59N64.8N64.81N64.82N64.89N64.9N65N65.0N65.1Updates & Changes
FY 2026 Updates
New Codes (2)
Revised Codes (1)
Deleted Codes(1)
Historical Changes
- •FY 2025: Routine maintenance updates with minor terminology clarifications
- •FY 2024: Enhanced specificity requirements for certain code ranges
- •FY 2023: Updated documentation guidelines for improved clarity
Upcoming Changes
- •Proposed updates pending review by Coordination and Maintenance Committee
- •Under consideration: Enhanced digital health integration codes
Implementation Guidance
- •Review all FY 2026 updates for N60-N65 codes before implementation
- •Always verify the most current codes in the ICD-10-CM manual
- •Ensure clinical documentation supports the selected diagnosis codes
- +3 more guidance items...
Range Overview
The ICD-10 category N60-N65 covers a range of disorders of the breast. These codes are used to document various breast conditions such as cystic mastopathy (N60), fibroadenosis (N61), mastitis (N61), other disorders of the breast (N64), and Mammographic microcalcification (N65). The codes are designed to provide detailed information about the type, location, and severity of the breast disorder, aiding in treatment planning and statistical tracking.
Key Usage Points:
- •Always use specific codes that describe the diagnosis to the highest level of specificity.
- •Remember to code also any associated underlying condition first.
- •Use additional code to identify estrogen receptor status (Z17.0, Z17.1).
- •For postprocedural disorders, code to complication of procedure (T81.-).
Coding Guidelines
When to Use:
- ✓Patient diagnosed with fibrocystic breast disease (N60.1).
- ✓Patient with lactational mastitis (N61.0).
- ✓Patient with nipple discharge (N64.52).
- ✓Patient with mammographic calcification found (N65.0).
When NOT to Use:
- ✗Patient with breast cancer (use C50.-).
- ✗Patient with gynecomastia (use E30.0).
- ✗Patient with mastodynia (use N64.4).
- ✗Patient with postprocedural disorders (use T81.-).
Code Exclusions
Always verify exclusions against the patient's medical record to ensure accurate coding.
Documentation Requirements
Documentation for disorders of the breast should include a detailed description of the condition, its location, and severity. Any associated conditions or complications should also be documented.
Clinical Information:
- •Specific diagnosis
- •Location of the condition
- •Severity of the condition
- •Any associated conditions or complications
- •Estrogen receptor status if applicable
Supporting Evidence:
- •Clinical notes
- •Lab reports
- •Imaging reports
- •Surgical reports
Good Documentation Example:
Patient diagnosed with fibrocystic breast disease, located in the upper outer quadrant of the right breast. Condition is moderate in severity. Estrogen receptor status is positive.
Poor Documentation Example:
Patient has a breast condition.
Common Documentation Errors:
- âš Not specifying the location of the condition
- âš Not documenting the severity of the condition
- âš Not documenting associated conditions or complications
- âš Not documenting estrogen receptor status if applicable
Range Statistics
Coding Complexity
The coding complexity for disorders of the breast is considered medium. While the codes themselves are straightforward, the complexity comes from understanding the various types of breast disorders, determining the correct code based on the location and severity of the condition, identifying any associated conditions or complications, and understanding the exclusions for this category.
Key Factors:
- â–¸Understanding the various types of breast disorders
- â–¸Determining the correct code based on the location and severity of the condition
- â–¸Identifying any associated conditions or complications
- â–¸Understanding the exclusions for this category
Specialty Focus
These codes are most commonly used in specialties that deal with breast health, such as general surgery, oncology, and obstetrics and gynecology.
Primary Specialties:
Clinical Scenarios:
- • Patient with fibrocystic breast disease
- • Patient with lactational mastitis
- • Patient with nipple discharge
- • Patient with mammographic calcification found
Resources & References
The official ICD-10 guidelines and the American Hospital Association's Coding Clinic are valuable resources for coding disorders of the breast. Clinical references such as medical textbooks and journal articles can also provide useful information.
Official Guidelines:
- ICD-10-CM Official Guidelines for Coding and Reporting
- American Hospital Association's Coding Clinic
Clinical References:
- Medical textbooks
- Journal articles
Educational Materials:
- ICD-10 coding training materials
- Webinars and online courses on ICD-10 coding
Frequently Asked Questions
Can I use N60-N65 codes for breast cancer?
No, breast cancer has its own specific codes in the C50.- category.