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v1.0.0
ICD-10 Guide
ICD-10 CodesR92.30

R92.30

Dense breasts, unspecified

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

Code Description

ICD-10 R92.30 is a billable code used to indicate a diagnosis of dense breasts, unspecified.

Key Diagnostic Point:

Dense breasts refer to breast tissue that has a higher proportion of glandular and fibrous tissue compared to fatty tissue, which can make it more difficult to detect abnormalities on mammograms. This condition is not classified as a disease but is a significant finding in breast imaging. Dense breast tissue can obscure tumors, leading to a higher risk of breast cancer being missed during screening. Women with dense breasts may experience no symptoms, but they may be informed of their breast density during routine mammograms. The clinical significance of dense breasts lies in the increased risk of breast cancer, necessitating additional screening methods such as ultrasound or MRI. The classification of breast density is typically assessed using the Breast Imaging Reporting and Data System (BI-RADS), which categorizes breast density into four levels. Dense breasts are common, particularly in younger women, and can change with age, hormonal factors, and body weight. Accurate documentation of breast density is crucial for appropriate patient management and follow-up.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in breast density assessment methods
  • Need for clear documentation of breast density findings
  • Potential for confusion with other breast-related codes
  • Inconsistent reporting practices among providers

Audit Risk Factors

  • Inadequate documentation of breast density findings
  • Failure to specify the type of breast density
  • Misuse of R92.30 when more specific codes are applicable
  • Inconsistent coding practices across different providers

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Documentation should include breast density assessment results, any related symptoms, and follow-up recommendations.

Common Clinical Scenarios

Routine screening mammograms revealing dense breast tissue without any palpable masses.

Billing Considerations

Internal medicine providers should ensure that patients are informed about the implications of dense breast tissue and the need for additional screening.

Emergency Medicine

Documentation Requirements

Acute care documentation should include any presenting symptoms, imaging results, and immediate management plans.

Common Clinical Scenarios

Patients presenting with breast pain or lumps who have a history of dense breast tissue.

Billing Considerations

Emergency providers should be aware of the implications of dense breasts when evaluating breast-related complaints.

Coding Guidelines

Inclusion Criteria

Use R92.30 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when breast density is documented and no other specific diagnosis is applicable

Exclusion Criteria

Do NOT use R92.30 When
No specific exclusions found.

Related CPT Codes

77067CPT Code

Mammography, bilateral, diagnostic

Clinical Scenario

Used when dense breast tissue is identified during screening, necessitating further evaluation.

Documentation Requirements

Document the reason for the diagnostic mammogram and any findings.

Specialty Considerations

Radiologists should ensure that breast density is clearly documented in reports.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of breast density, improving the ability to track and manage patient care related to breast cancer risk.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of breast density, improving the ability to track and manage patient care related to breast cancer risk.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of breast density, improving the ability to track and manage patient care related to breast cancer risk.

Resources

Clinical References

  • •
    Breast Imaging Reporting and Data System (BI-RADS)

Coding & Billing References

  • •
    Breast Imaging Reporting and Data System (BI-RADS)

Frequently Asked Questions

What does it mean to have dense breasts?

Having dense breasts means that the breast tissue is composed of more glandular and fibrous tissue than fatty tissue, which can make it harder to detect abnormalities on mammograms.

Is dense breast tissue a risk factor for breast cancer?

Yes, women with dense breast tissue have a higher risk of developing breast cancer, which is why additional screening may be recommended.