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v1.0.0
ICD-10 Guide
DiagnosesFibrocystic Breast Disease

Fibrocystic Breast Disease

ICD-10 Coding for Fibrocystic Breast Disease(N60.3, N60.19)

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

Diagnosis Overview

What is Fibrocystic Breast Disease?
Essential facts and insights about Fibrocystic Breast Disease

Key Clinical Considerations:

  • Breast pain or tenderness
  • Lumpy or nodular breast tissue
  • Cyclical changes in breast symptoms related to menstrual cycle

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history of breast symptoms
  • Results of imaging studies (e.g., mammography, ultrasound)
  • Physical examination findings including breast palpation results

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for fibrocystic changes vs. other breast conditions.
  • Common errors include misclassifying benign vs. malignant findings.

Code Exclusions

Important Exclusions

  • Breast cancer, mastitis, and other breast pathologies
  • Alternative codes for benign breast conditions

Related ICD-10 Codes

Primary Codes
N60.1
Fibrocystic breast disease
Ancillary Codes
R92.2
Differential Codes
N60.19
N60.19
for diffuse cystic changes without epithelial proliferation.
N60.3
N60.3
when epithelial proliferation is present.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Radiology

Specialty Applications

  • Women of reproductive age, especially those with cyclical breast symptoms
  • Radiology departments performing breast imaging

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

Documentation requirements?

Document patient symptoms, imaging results, and physical exam findings.

Billing considerations?

Ensure accurate coding to reflect the diagnosis and any imaging performed.