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v1.0.0
ICD-10 Guide
ICD-10 CodesQ83.1

Q83.1

Billable

Accessory breast

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 Q83.1 is a billable code used to indicate a diagnosis of accessory breast.

Key Diagnostic Point:

Accessory breast, also known as polymastia, is a congenital condition characterized by the presence of additional breast tissue beyond the normal two breasts. This condition can occur in both males and females and may present as small nodules of breast tissue located anywhere along the milk line, which extends from the axilla to the groin. Accessory breasts can vary in size and may or may not have associated nipple and areola structures. While often asymptomatic, they can lead to complications such as pain, infection, or cosmetic concerns, prompting surgical intervention. The condition is thought to arise from abnormal development during embryogenesis, particularly during the formation of the mammary glands. Accessory breast tissue may also be associated with other congenital anomalies, including those affecting the skin, spleen, or adrenal glands, necessitating a comprehensive evaluation of the patient for any coexisting conditions. Accurate coding of accessory breast is essential for proper management and treatment planning, especially in pediatric populations where early intervention may be beneficial.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and size of accessory breast tissue
  • Potential for associated congenital anomalies
  • Need for differentiation from other breast conditions
  • Documentation of symptoms and complications

Audit Risk Factors

  • Inadequate documentation of the presence and characteristics of accessory breast tissue
  • Failure to document associated symptoms or complications
  • Misclassification of accessory breast as a malignant condition
  • Lack of clarity in the surgical intervention performed

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed physical examination findings, including size and location of accessory breast tissue, and any associated symptoms.

Common Clinical Scenarios

Pediatric patients presenting with accessory breast tissue during routine examinations or with complaints of pain or discomfort.

Billing Considerations

Consideration of psychosocial impacts on pediatric patients and the need for family counseling regarding the condition.

Genetics

Documentation Requirements

Family history of congenital conditions, genetic testing results if applicable, and any syndromic associations.

Common Clinical Scenarios

Patients with accessory breast tissue presenting for genetic counseling due to family history of congenital anomalies.

Billing Considerations

Assessment for syndromic associations that may indicate a broader genetic condition.

Coding Guidelines

Inclusion Criteria

Use Q83.1 When
  • Follow official ICD
  • CM guidelines for coding congenital conditions, ensuring accurate documentation of the condition's characteristics and any associated anomalies

Exclusion Criteria

Do NOT use Q83.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

19301CPT Code

Mastectomy, partial

Clinical Scenario

Used when surgical intervention is performed to remove accessory breast tissue.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Considerations for pediatric patients and potential for future breast development.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital conditions like accessory breast, improving data accuracy and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions like accessory breast, improving data accuracy and facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital conditions like accessory breast, improving data accuracy and facilitating better patient management.

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 is the significance of coding accessory breast accurately?

Accurate coding of accessory breast is crucial for appropriate management and treatment planning. It ensures that patients receive the necessary interventions and helps in tracking congenital conditions for research and epidemiological purposes.