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v1.0.0
ICD-10 Guide
ICD-10 CodesN64.2

N64.2

Billable

Atrophy of breast

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/18/2025

Code Description

ICD-10 N64.2 is a billable code used to indicate a diagnosis of atrophy of breast.

Key Diagnostic Point:

Atrophy of the breast refers to the reduction in size and volume of breast tissue, which can occur due to various factors including hormonal changes, aging, or certain medical conditions. This condition is often benign and may not present with significant symptoms. However, it can be associated with other breast diseases such as mastitis, which is an infection that can lead to inflammation and changes in breast tissue. In some cases, atrophy may be linked to breast hypertrophy, where the breast tissue is excessively developed, leading to a compensatory reduction in size. Breast lumps and nipple discharge may also be present in patients with atrophy, necessitating thorough evaluation through imaging studies such as mammography or ultrasound. These imaging modalities help differentiate atrophy from other pathological conditions, ensuring accurate diagnosis and management. Understanding the underlying causes of breast atrophy is crucial for appropriate treatment and patient education.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between atrophy and other breast conditions
  • Need for comprehensive patient history and hormonal assessment
  • Potential overlap with other ICD-10 codes related to breast diseases
  • Documentation of associated symptoms such as lumps or discharge

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to document associated symptoms
  • Misuse of related codes leading to upcoding or downcoding
  • Lack of clarity in distinguishing atrophy from malignancy

Specialty Focus

Medical Specialties

Oncology

Documentation Requirements

Detailed history of breast changes, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with breast atrophy alongside a history of breast cancer treatment.

Billing Considerations

Ensure clear documentation of any malignancy history to avoid misdiagnosis.

Endocrinology

Documentation Requirements

Hormonal assessment results, including thyroid and reproductive hormones.

Common Clinical Scenarios

Patients with hormonal imbalances presenting with breast atrophy.

Billing Considerations

Document any hormonal therapies that may influence breast tissue changes.

Coding Guidelines

Inclusion Criteria

Use N64.2 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the condition and any associated symptoms
  • Include relevant clinical findings and imaging results to support the diagnosis

Exclusion Criteria

Do NOT use N64.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

77067CPT Code

Mammography, bilateral

Clinical Scenario

Used for screening in patients with breast atrophy to rule out malignancy.

Documentation Requirements

Document the reason for the mammogram and any findings.

Specialty Considerations

Oncology specialists should ensure imaging is aligned with treatment plans.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of breast conditions, including atrophy, which aids in better tracking and management of breast health issues.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of breast conditions, including atrophy, which aids in better tracking and management of breast health issues.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of breast conditions, including atrophy, which aids in better tracking and management of breast health issues.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common causes of breast atrophy?

Common causes include hormonal changes, aging, and certain medical treatments such as chemotherapy or radiation therapy.