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ICD-10 Guide
DiagnosesAbsceso Erythema Nodosum Mama

Absceso Erythema Nodosum Mama

ICD-10 Coding for Breast Abscess with Erythema Nodosum(O91.13, O91.12, L52)

PRIMARY SPECIALTYObstetrics and Gynecology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Absceso Erythema Nodosum Mama?
Essential facts and insights about Breast Abscess with Erythema Nodosum

Key Clinical Considerations:

  • Painful, erythematous nodules on the breast
  • Ultrasound showing abscess formation
  • Palpable mass with tenderness on examination

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history including onset and duration of symptoms
  • Detailed description of physical exam findings
  • Imaging results and any interventions performed

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for coding abscesses versus other breast conditions.
  • Common errors include misclassifying the type of abscess or failing to document associated symptoms.

Code Exclusions

Important Exclusions

  • Mastitis without abscess formation
  • Other breast lesions such as cysts or tumors

Related ICD-10 Codes

Primary Codes
L02.211
Abscess of breast
Ancillary Codes
B95.6
B96.21
Differential Codes
N61.2
N61.2
for abscesses not related to lactation or puerperium.
L98.3
L98.3
for panniculitis not classified as erythema nodosum.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Obstetrics and Gynecology

Specialty Applications

  • Women of reproductive age, particularly those with a history of inflammatory breast conditions
  • Obstetric and gynecological clinical settings

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What are the documentation requirements?

Document the clinical presentation, imaging results, and treatment plan.

What are the billing considerations?

Ensure accurate coding to reflect the complexity of the case and any procedures performed.