DRG 601

Non-malignant breast disorders without cc/mcc

  • D49.3
    Neoplasm of unspecified behavior of breast
  • I97.2
    Postmastectomy lymphedema syndrome
  • N60.01
    Solitary cyst of right breast
  • N60.02
    Solitary cyst of left breast
  • N60.09
    Solitary cyst of unspecified breast
  • N60.11
    Diffuse cystic mastopathy of right breast
  • N60.12
    Diffuse cystic mastopathy of left breast
  • N60.19
    Diffuse cystic mastopathy of unspecified breast
  • N60.21
    Fibroadenosis of right breast
  • N60.22
    Fibroadenosis of left breast
  • N60.29
    Fibroadenosis of unspecified breast
  • N60.31
    Fibrosclerosis of right breast
  • N60.32
    Fibrosclerosis of left breast
  • N60.39
    Fibrosclerosis of unspecified breast
  • N60.41
    Mammary duct ectasia of right breast
  • N60.42
    Mammary duct ectasia of left breast
  • N60.49
    Mammary duct ectasia of unspecified breast
  • N60.81
    Other benign mammary dysplasias of right breast
  • N60.82
    Other benign mammary dysplasias of left breast
  • N60.89
    Other benign mammary dysplasias of unspecified breast
  • N60.91
    Unspecified benign mammary dysplasia of right breast
  • N60.92
    Unspecified benign mammary dysplasia of left breast
  • N60.99
    Unspecified benign mammary dysplasia of unspecified breast
  • N61.0
    Mastitis without abscess
  • N61.1
    Abscess of the breast and nipple
  • N62
    Hypertrophy of breast
  • N63.0
    Unspecified lump in unspecified breast
  • N63.10
    Unspecified lump in the right breast, unspecified quadrant
  • N63.11
    Unspecified lump in the right breast, upper outer quadrant
  • N63.12
    Unspecified lump in the right breast, upper inner quadrant
  • N63.13
    Unspecified lump in the right breast, lower outer quadrant
  • N63.14
    Unspecified lump in the right breast, lower inner quadrant
  • N63.15
    Unspecified lump in the right breast, overlapping quadrants
  • N63.20
    Unspecified lump in the left breast, unspecified quadrant
  • N63.21
    Unspecified lump in the left breast, upper outer quadrant
  • N63.22
    Unspecified lump in the left breast, upper inner quadrant
  • N63.23
    Unspecified lump in the left breast, lower outer quadrant
  • N63.24
    Unspecified lump in the left breast, lower inner quadrant
  • N63.25
    Unspecified lump in the left breast, overlapping quadrants
  • N63.31
    Unspecified lump in axillary tail of the right breast
  • N63.32
    Unspecified lump in axillary tail of the left breast
  • N63.41
    Unspecified lump in right breast, subareolar
  • N63.42
    Unspecified lump in left breast, subareolar
  • N64.0
    Fissure and fistula of nipple
  • N64.1
    Fat necrosis of breast
  • N64.2
    Atrophy of breast
  • N64.3
    Galactorrhea not associated with childbirth
  • N64.4
    Mastodynia
  • N64.51
    Induration of breast
  • N64.52
    Nipple discharge
  • N64.53
    Retraction of nipple
  • N64.59
    Other signs and symptoms in breast
  • N64.81
    Ptosis of breast
  • N64.82
    Hypoplasia of breast
  • N64.89
    Other specified disorders of breast
  • N64.9
    Disorder of breast, unspecified
  • N65.0
    Deformity of reconstructed breast
  • N65.1
    Disproportion of reconstructed breast
  • Q83.0
    Congenital absence of breast with absent nipple
  • Q83.1
    Accessory breast
  • Q83.2
    Absent nipple
  • Q83.3
    Accessory nipple
  • Q83.8
    Other congenital malformations of breast
  • Q83.9
    Congenital malformation of breast, unspecified
  • R92.0
    Mammographic microcalcification found on diagnostic imaging of breast
  • R92.1
    Mammographic calcification found on diagnostic imaging of breast
  • R92.2
    Inconclusive mammogram
  • R92.8
    Other abnormal and inconclusive findings on diagnostic imaging of breast
  • T85.41XA
    Breakdown (mechanical) of breast prosthesis and implant, initial encounter
  • T85.42XA
    Displacement of breast prosthesis and implant, initial encounter
  • T85.43XA
    Leakage of breast prosthesis and implant, initial encounter
  • T85.44XA
    Capsular contracture of breast implant, initial encounter
  • T85.49XA
    Other mechanical complication of breast prosthesis and implant, initial encounter
  • Z40.01
    Encounter for prophylactic removal of breast
ICD-10-CM D49.3

Neoplasm of unspecified behavior of breast

    2016 2017 2018 2019 2020 Billable/Specific Code
Type 1 Excludes
  • neoplasm of unspecified behavior of skin of breast (D49.2)
ICD-10-CM I97.2

Postmastectomy lymphedema syndrome

    2016 2017 2018 2019 2020 Billable/Specific Code Adult Dx (15-124 years)
Applicable To
  • Elephantiasis due to mastectomy
  • Obliteration of lymphatic vessels
ICD-10-CM N60.01

Solitary cyst of right breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.02

Solitary cyst of left breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.09

Solitary cyst of unspecified breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.11

Diffuse cystic mastopathy of right breast

    2016 2017 2018 2019 2020 Billable/Specific Code Adult Dx (15-124 years)
ICD-10-CM N60.12

Diffuse cystic mastopathy of left breast

    2016 2017 2018 2019 2020 Billable/Specific Code Adult Dx (15-124 years)
ICD-10-CM N60.19

Diffuse cystic mastopathy of unspecified breast

    2016 2017 2018 2019 2020 Billable/Specific Code Adult Dx (15-124 years)
ICD-10-CM N60.21

Fibroadenosis of right breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.22

Fibroadenosis of left breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.29

Fibroadenosis of unspecified breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.31

Fibrosclerosis of right breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.32

Fibrosclerosis of left breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.39

Fibrosclerosis of unspecified breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.41

Mammary duct ectasia of right breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.42

Mammary duct ectasia of left breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.49

Mammary duct ectasia of unspecified breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.81

Other benign mammary dysplasias of right breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.82

Other benign mammary dysplasias of left breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.89

Other benign mammary dysplasias of unspecified breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.91

Unspecified benign mammary dysplasia of right breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.92

Unspecified benign mammary dysplasia of left breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N60.99

Unspecified benign mammary dysplasia of unspecified breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N61.0

Mastitis without abscess

    2017 - New Code 2018 2019 2020 Billable/Specific Code
Applicable To
  • Infective mastitis (acute) (nonpuerperal) (subacute)
  • Mastitis (acute) (nonpuerperal) (subacute) NOS
  • Cellulitis (acute) (nonpuerperal) (subacute) of breast NOS
  • Cellulitis (acute) (nonpuerperal) (subacute) of nipple NOS
ICD-10-CM N61.1

Abscess of the breast and nipple

    2017 - New Code 2018 2019 2020 Billable/Specific Code
Applicable To
  • Abscess (acute) (chronic) (nonpuerperal) of areola
  • Abscess (acute) (chronic) (nonpuerperal) of breast
  • Carbuncle of breast
  • Mastitis with abscess
ICD-10-CM N62

Hypertrophy of breast

    2016 2017 2018 2019 2020 Billable/Specific Code
Applicable To
  • Gynecomastia
  • Hypertrophy of breast NOS
  • Massive pubertal hypertrophy of breast
Type 1 Excludes
  • breast engorgement of newborn (P83.4)
  • disproportion of reconstructed breast (N65.1)
ICD-10-CM N63.0

Unspecified lump in unspecified breast

    2018 - New Code 2019 - Revised Code 2020 Billable/Specific Code
ICD-10-CM N63.10

Unspecified lump in the right breast, unspecified quadrant

    2018 - New Code 2019 2020 Billable/Specific Code
ICD-10-CM N63.11

Unspecified lump in the right breast, upper outer quadrant

    2018 - New Code 2019 2020 Billable/Specific Code
ICD-10-CM N63.12

Unspecified lump in the right breast, upper inner quadrant

    2018 - New Code 2019 2020 Billable/Specific Code
ICD-10-CM N63.13

Unspecified lump in the right breast, lower outer quadrant

    2018 - New Code 2019 2020 Billable/Specific Code
ICD-10-CM N63.14

Unspecified lump in the right breast, lower inner quadrant

    2018 - New Code 2019 2020 Billable/Specific Code
ICD-10-CM N63.15

Unspecified lump in the right breast, overlapping quadrants

    2020 - New Code Billable/Specific Code
ICD-10-CM N63.20

Unspecified lump in the left breast, unspecified quadrant

    2018 - New Code 2019 2020 Billable/Specific Code
ICD-10-CM N63.21

Unspecified lump in the left breast, upper outer quadrant

    2018 - New Code 2019 2020 Billable/Specific Code
ICD-10-CM N63.22

Unspecified lump in the left breast, upper inner quadrant

    2018 - New Code 2019 2020 Billable/Specific Code
ICD-10-CM N63.23

Unspecified lump in the left breast, lower outer quadrant

    2018 - New Code 2019 2020 Billable/Specific Code
ICD-10-CM N63.24

Unspecified lump in the left breast, lower inner quadrant

    2018 - New Code 2019 2020 Billable/Specific Code
ICD-10-CM N63.25

Unspecified lump in the left breast, overlapping quadrants

    2020 - New Code Billable/Specific Code
ICD-10-CM N63.31

Unspecified lump in axillary tail of the right breast

    2018 - New Code 2019 2020 Billable/Specific Code
ICD-10-CM N63.32

Unspecified lump in axillary tail of the left breast

    2018 - New Code 2019 2020 Billable/Specific Code
ICD-10-CM N63.41

Unspecified lump in right breast, subareolar

    2018 - New Code 2019 2020 Billable/Specific Code
ICD-10-CM N63.42

Unspecified lump in left breast, subareolar

    2018 - New Code 2019 2020 Billable/Specific Code
ICD-10-CM N64.0

Fissure and fistula of nipple

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N64.1

Fat necrosis of breast

    2016 2017 2018 2019 2020 Billable/Specific Code
Applicable To
  • Fat necrosis (segmental) of breast
Code First
  • breast necrosis due to breast graft (T85.898)
ICD-10-CM N64.2

Atrophy of breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N64.3

Galactorrhea not associated with childbirth

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N64.4

Mastodynia

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N64.51

Induration of breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N64.52

Nipple discharge

    2016 2017 2018 2019 2020 Billable/Specific Code
Type 1 Excludes
  • abnormal findings in nipple discharge (R89.-)
ICD-10-CM N64.53

Retraction of nipple

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N64.59

Other signs and symptoms in breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N64.81

Ptosis of breast

    2016 2017 2018 2019 2020 Billable/Specific Code Adult Dx (15-124 years)
Type 1 Excludes
  • ptosis of native breast in relation to reconstructed breast (N65.1)
ICD-10-CM N64.82

Hypoplasia of breast

    2016 2017 2018 2019 2020 Billable/Specific Code Adult Dx (15-124 years)
Applicable To
  • Micromastia
Type 1 Excludes
  • congenital absence of breast (Q83.0)
  • hypoplasia of native breast in relation to reconstructed breast (N65.1)
ICD-10-CM N64.89

Other specified disorders of breast

    2016 2017 2018 2019 2020 Billable/Specific Code
Applicable To
  • Galactocele
  • Subinvolution of breast (postlactational)
ICD-10-CM N64.9

Disorder of breast, unspecified

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM N65.0

Deformity of reconstructed breast

    2016 2017 2018 2019 2020 Billable/Specific Code Adult Dx (15-124 years)
Applicable To
  • Contour irregularity in reconstructed breast
  • Excess tissue in reconstructed breast
  • Misshapen reconstructed breast
ICD-10-CM N65.1

Disproportion of reconstructed breast

    2016 2017 2018 2019 2020 Billable/Specific Code Adult Dx (15-124 years)
Applicable To
  • Breast asymmetry between native breast and reconstructed breast
  • Disproportion between native breast and reconstructed breast
ICD-10-CM Q83.0

Congenital absence of breast with absent nipple

    2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
ICD-10-CM Q83.1

Accessory breast

    2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
Applicable To
  • Supernumerary breast
ICD-10-CM Q83.2

Absent nipple

    2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
ICD-10-CM Q83.3

Accessory nipple

    2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
Applicable To
  • Supernumerary nipple
ICD-10-CM Q83.8

Other congenital malformations of breast

    2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
ICD-10-CM Q83.9

Congenital malformation of breast, unspecified

    2016 2017 2018 2019 2020 Billable/Specific Code POA Exempt
ICD-10-CM R92.0

Mammographic microcalcification found on diagnostic imaging of breast

    2016 2017 2018 2019 2020 Billable/Specific Code
Type 2 Excludes
  • mammographic calcification (calculus) found on diagnostic imaging of breast (R92.1)
ICD-10-CM R92.1

Mammographic calcification found on diagnostic imaging of breast

    2016 2017 2018 2019 2020 Billable/Specific Code
Applicable To
  • Mammographic calculus found on diagnostic imaging of breast
ICD-10-CM R92.2

Inconclusive mammogram

    2016 2017 2018 2019 2020 Billable/Specific Code
Applicable To
  • Dense breasts NOS
  • Inconclusive mammogram NEC
  • Inconclusive mammography due to dense breasts
  • Inconclusive mammography NEC
ICD-10-CM R92.8

Other abnormal and inconclusive findings on diagnostic imaging of breast

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM T85.41XA

Breakdown (mechanical) of breast prosthesis and implant, initial encounter

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM T85.42XA

Displacement of breast prosthesis and implant, initial encounter

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM T85.43XA

Leakage of breast prosthesis and implant, initial encounter

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM T85.44XA

Capsular contracture of breast implant, initial encounter

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM T85.49XA

Other mechanical complication of breast prosthesis and implant, initial encounter

    2016 2017 2018 2019 2020 Billable/Specific Code
ICD-10-CM Z40.01

Encounter for prophylactic removal of breast

    2016 2017 2018 2019 2020 Billable/Specific Code