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v1.0.0
ICD-10 Guide
ICD-10 CodesP39.0

P39.0

Billable

Neonatal infective mastitis

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

Code Description

ICD-10 P39.0 is a billable code used to indicate a diagnosis of neonatal infective mastitis.

Key Diagnostic Point:

Neonatal infective mastitis is an infection of the breast tissue that can occur in newborns, typically presenting as unilateral or bilateral swelling, redness, and tenderness of the breast. This condition is often due to bacterial infection, most commonly Staphylococcus aureus, which can be transmitted from the mother during breastfeeding or through skin-to-skin contact. The infection may lead to the formation of abscesses if not treated promptly. Clinical management includes antibiotic therapy and, in some cases, drainage of any abscesses. It is crucial for healthcare providers to differentiate between infective mastitis and other breast-related conditions in neonates, such as physiological breast enlargement or galactorrhea, to ensure appropriate treatment. Early recognition and intervention are essential to prevent complications and promote recovery in affected infants.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other breast conditions in neonates
  • Need for accurate documentation of clinical findings
  • Potential for co-existing infections
  • Variability in presentation among different newborns

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the type of infection
  • Misclassification of the condition as non-infective
  • Lack of follow-up documentation on treatment outcomes

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed clinical notes on the infant's symptoms, maternal history, and treatment plan.

Common Clinical Scenarios

A newborn presents with unilateral breast swelling and fever; the mother has a history of mastitis.

Billing Considerations

Consideration of the infant's gestational age and overall health status when coding.

Pediatrics

Documentation Requirements

Comprehensive documentation of the infant's growth, feeding patterns, and any signs of systemic infection.

Common Clinical Scenarios

A pediatric visit for a newborn with breast tenderness and irritability, requiring evaluation for mastitis.

Billing Considerations

Awareness of the potential for complications and the need for interdisciplinary communication.

Coding Guidelines

Inclusion Criteria

Use P39.0 When
  • Follow the ICD
  • CM guidelines for coding infections, ensuring specificity in the diagnosis and linking to appropriate treatment codes
  • Documentation must support the diagnosis and any associated conditions

Exclusion Criteria

Do NOT use P39.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99291CPT Code

Critical care, evaluation and management of the neonate

Clinical Scenario

Used when a newborn with P39.0 requires critical care due to severe infection.

Documentation Requirements

Detailed notes on the infant's condition and treatment plan.

Specialty Considerations

Neonatologists must document the severity of the condition and the rationale for critical care.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding neonatal conditions, including P39.0, which helps in better tracking and management of neonatal infections.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding neonatal conditions, including P39.0, which helps in better tracking and management of neonatal infections.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding neonatal conditions, including P39.0, which helps in better tracking and management of neonatal infections.

Resources

Clinical References

  • •
    ICD-10-CM Coding Guidelines

Coding & Billing References

  • •
    ICD-10-CM Coding Guidelines

Frequently Asked Questions

What are the common signs of neonatal infective mastitis?

Common signs include unilateral or bilateral breast swelling, redness, tenderness, and sometimes fever in the newborn. Prompt evaluation is necessary to confirm the diagnosis and initiate treatment.