Granulomatous mastitis, bilateral breast
ICD-10 N61.23 is a billable code used to indicate a diagnosis of granulomatous mastitis, bilateral breast.
Granulomatous mastitis is a rare inflammatory condition of the breast characterized by the formation of granulomas, which are small areas of inflammation. This condition can occur bilaterally, affecting both breasts, and is often associated with a history of breastfeeding or autoimmune diseases. Patients may present with breast lumps, nipple discharge, and localized pain or tenderness. The diagnosis is typically confirmed through imaging studies such as mammography or ultrasound, followed by a biopsy to rule out malignancy. Granulomatous mastitis is considered a benign breast disease, but it can mimic more serious conditions, making accurate diagnosis and coding essential. Treatment may involve corticosteroids or surgical intervention, depending on the severity of symptoms and the extent of the disease. Understanding the clinical presentation and imaging findings is crucial for coders to ensure proper documentation and coding of this condition.
Detailed surgical notes, imaging results, and pathology reports are essential.
Patients presenting with breast lumps, pain, or discharge requiring surgical evaluation.
Ensure clear documentation of the surgical approach and any findings during the procedure.
Comprehensive imaging reports detailing findings and recommendations.
Imaging studies performed for patients with suspected breast conditions.
Radiologists should provide clear descriptions of imaging findings to support coding.
Used when a biopsy is performed to confirm granulomatous mastitis.
Document the indication for biopsy and findings.
Ensure that the procedure is linked to the diagnosis of granulomatous mastitis.
Common symptoms include breast lumps, pain, swelling, and sometimes nipple discharge. Patients may also experience tenderness in the affected areas.
Diagnosis typically involves clinical examination, imaging studies such as ultrasound or mammography, and confirmation through biopsy.
Treatment may include corticosteroids to reduce inflammation or surgical intervention if necessary. The approach depends on the severity of symptoms and the extent of the disease.
