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ICD-10 Guide
ICD-10 CodesQ83.8

Q83.8

Billable

Other congenital malformations of breast

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

Code Description

ICD-10 Q83.8 is a billable code used to indicate a diagnosis of other congenital malformations of breast.

Key Diagnostic Point:

Congenital malformations of the breast can encompass a variety of conditions that affect the development and structure of breast tissue. These malformations may include conditions such as accessory breast tissue, breast hypoplasia, or breast agenesis. These anomalies can arise from genetic factors, environmental influences, or a combination of both during fetal development. The clinical presentation can vary widely, with some individuals experiencing no significant functional impairment, while others may face psychosocial challenges or require surgical intervention. Accurate diagnosis often involves imaging studies, such as ultrasound or MRI, and may necessitate a multidisciplinary approach including pediatricians, geneticists, and plastic surgeons. Understanding the underlying genetic syndromes associated with breast malformations is crucial, as these conditions can sometimes be part of broader syndromic presentations, necessitating comprehensive genetic evaluation and counseling.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of malformations
  • Need for multidisciplinary documentation and collaboration
  • Potential association with genetic syndromes requiring additional codes
  • Differentiation from acquired breast conditions

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to document associated syndromes or conditions
  • Misclassification of congenital versus acquired conditions
  • Lack of genetic testing results in the medical record

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed growth and development assessments, family history, and any associated anomalies.

Common Clinical Scenarios

Evaluation of breast anomalies in newborns, assessment of psychosocial impact in adolescents.

Billing Considerations

Consideration of the developmental stage of the patient and potential need for surgical intervention.

Genetics

Documentation Requirements

Genetic testing results, family pedigree, and syndromic associations.

Common Clinical Scenarios

Genetic counseling for families with a history of congenital breast malformations.

Billing Considerations

Understanding the genetic basis of malformations and implications for family members.

Coding Guidelines

Inclusion Criteria

Use Q83.8 When
  • Follow ICD
  • CM guidelines for coding congenital conditions, ensuring specificity and accuracy in documentation
  • Consider the need for additional codes if associated syndromes are present

Exclusion Criteria

Do NOT use Q83.8 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

19316CPT Code

Breast reconstruction, including mastectomy

Clinical Scenario

Used in cases of significant breast malformation requiring surgical intervention.

Documentation Requirements

Detailed operative report and pre-operative assessments.

Specialty Considerations

Plastic surgery documentation must align with congenital diagnosis.

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, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital conditions, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 congenital breast malformations?

Common congenital breast malformations include breast agenesis, hypoplasia, and accessory breast tissue. Each condition may have different implications for treatment and management.