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ICD-10 Guide
ICD-10 CodesChapter 14: Diseases of the genitourinary systemN62

N62

Billable

Hypertrophy of breast

Chapter 14:Diseases of the genitourinary system

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/18/2025

Code Description

ICD-10 N62 is a billable code used to indicate a diagnosis of hypertrophy of breast.

Key Diagnostic Point:

Hypertrophy of the breast, classified under ICD-10 code N62, refers to an abnormal enlargement of breast tissue that can occur in both males and females. This condition may arise due to various factors, including hormonal imbalances, genetic predisposition, or as a result of benign breast diseases such as fibrocystic changes or lipomas. Patients may present with symptoms such as breast lumps, nipple discharge, or discomfort, which can lead to further investigation through imaging studies like mammography or ultrasound. In some cases, hypertrophy can be associated with mastitis, an inflammatory condition of the breast, particularly in lactating women. The diagnosis of breast hypertrophy often requires a thorough clinical evaluation, including a physical examination and imaging, to rule out malignancy or other underlying conditions. Treatment options may vary from conservative management to surgical intervention, depending on the severity of symptoms and the impact on the patient's quality of life.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between hypertrophy and other breast conditions.
  • Need for comprehensive documentation of symptoms and imaging results.
  • Potential overlap with other ICD-10 codes related to breast disorders.
  • Variability in clinical presentation among patients.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Failure to include imaging results in the medical record.
  • Misclassification of hypertrophy as a malignant condition.
  • Inconsistent coding practices among different providers.

Specialty Focus

Medical Specialties

Breast Surgery

Documentation Requirements

Detailed surgical notes, imaging results, and patient history.

Common Clinical Scenarios

Surgical intervention for symptomatic breast hypertrophy.

Billing Considerations

Ensure clear documentation of the rationale for surgery and any pre-operative assessments.

Endocrinology

Documentation Requirements

Hormonal assessment results and patient history regarding endocrine disorders.

Common Clinical Scenarios

Evaluation of hormonal imbalances contributing to breast hypertrophy.

Billing Considerations

Document any hormonal treatments or interventions that may affect breast tissue.

Coding Guidelines

Inclusion Criteria

Use N62 When
  • According to official coding guidelines, N62 should be used when there is a clear diagnosis of breast hypertrophy
  • It is important to document the clinical findings, imaging results, and any associated symptoms

Exclusion Criteria

Do NOT use N62 When
  • Exclusion criteria include conditions that may mimic hypertrophy, such as malignancies or significant inflammatory processes

Related CPT Codes

19316CPT Code

Reduction mammoplasty

Clinical Scenario

Performed for symptomatic breast hypertrophy.

Documentation Requirements

Pre-operative assessment, surgical notes, and post-operative follow-up.

Specialty Considerations

Breast surgeons should document the impact of hypertrophy on the patient's quality of life.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of breast conditions, including hypertrophy, which aids in better tracking and management of these conditions in clinical practice.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of breast conditions, including hypertrophy, which aids in better tracking and management of these conditions in clinical practice.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of breast conditions, including hypertrophy, which aids in better tracking and management of these conditions in clinical practice.

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 is the primary cause of breast hypertrophy?

Breast hypertrophy can be caused by hormonal imbalances, genetic factors, or benign breast diseases. It is important to evaluate each patient individually to determine the underlying cause.