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ICD-10 Guide
ICD-10 CodesP83.4

P83.4

Billable

Breast engorgement of newborn

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

Code Description

ICD-10 P83.4 is a billable code used to indicate a diagnosis of breast engorgement of newborn.

Key Diagnostic Point:

Breast engorgement in newborns is a condition characterized by the swelling and discomfort of the breast tissue due to the accumulation of milk or fluid. This condition typically arises in the first few days after birth, particularly in infants who are breastfed. It is often a result of hormonal changes that occur after delivery, leading to increased blood flow and fluid retention in the breast tissue. Symptoms may include firm, swollen breasts, tenderness, and sometimes, the presence of milk leakage. While breast engorgement is generally a self-limiting condition, it can lead to complications such as mastitis if not managed properly. Careful monitoring and appropriate breastfeeding techniques can help alleviate symptoms. It is essential for healthcare providers to educate parents on proper breastfeeding practices to prevent and manage this condition effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation among newborns
  • Differentiation from other breast-related conditions
  • Need for accurate documentation of breastfeeding practices
  • Potential for complications if not managed properly

Audit Risk Factors

  • Inadequate documentation of breastfeeding history
  • Failure to note associated symptoms or complications
  • Misclassification of the condition as more severe
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Documentation should include details on breastfeeding initiation, frequency, and any interventions taken to relieve engorgement.

Common Clinical Scenarios

Newborns presenting with breast engorgement in the NICU after maternal delivery, requiring monitoring and education for breastfeeding mothers.

Billing Considerations

Consideration of maternal health and breastfeeding support resources is crucial for accurate coding.

Pediatrics

Documentation Requirements

Pediatric documentation should reflect the infant's feeding patterns and any parental concerns regarding breast engorgement.

Common Clinical Scenarios

Pediatric visits where parents report concerns about breast engorgement and seek advice on management.

Billing Considerations

Pediatricians should be aware of the normal physiological changes in newborns and provide reassurance to parents.

Coding Guidelines

Inclusion Criteria

Use P83.4 When
  • 10 guidelines specify that P83
  • 4 should be used when breast engorgement is diagnosed in a newborn, ensuring that documentation supports the diagnosis and any associated care provided

Exclusion Criteria

Do NOT use P83.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99401CPT Code

Preventive medicine counseling

Clinical Scenario

Used when providing breastfeeding education to parents of a newborn with engorgement.

Documentation Requirements

Document the counseling provided, including topics discussed and parental understanding.

Specialty Considerations

Neonatologists should ensure that parents receive adequate support and resources.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like breast engorgement, improving the accuracy of diagnoses and treatment plans.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like breast engorgement, improving the accuracy of diagnoses and treatment plans.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like breast engorgement, improving the accuracy of diagnoses and treatment plans.

Resources

Clinical References

  • •
    Breastfeeding Support Resources

Coding & Billing References

  • •
    Breastfeeding Support Resources

Frequently Asked Questions

What are the signs of breast engorgement in newborns?

Signs include firm, swollen breasts, tenderness, and sometimes milk leakage. It typically occurs within the first few days after birth.