N61.1

N61.1: Abscess of the breast and nipple

Billable / specific codeICD-10-CM

N61.1 is a billable, specific ICD-10-CM code for abscess of the breast and nipple. It is valid for submission on a claim.

Check N61.1 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Abscess (acute) (chronic) (nonpuerperal) of areola
Abscess (acute) (chronic) (nonpuerperal) of breast
Carbuncle of breast
Mastitis with abscess

Excludes1 inherited from the categories above N61.1

A category’s note binds every code beneath it.

Written on N61: Inflammatory disorders of breast

inflammatory carcinoma of breast (C50.A-)
inflammatory disorder of breast associated with childbirth (O91.-)
neonatal infective mastitis (P39.0)
thrombophlebitis of breast [Mondor's disease] (I80.8)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

N61.1 is named in 5 Medicare coverage policies: 5 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52849Billing and Coding: Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography
A56448Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
A56658Billing and Coding: Cosmetic and Reconstructive Surgery

Alphabetic index entries that lead here

Abscess›areola(acute) (chronic) (nonpuerperal)
Abscess›breast(acute) (chronic) (nonpuerperal)
Abscess›nipple
Carbuncle›breast
Furuncle›breast
Mastitis›with abscess
Suppuration, suppurative›breast
Suppuration, suppurative›mammary gland
Ulcer, ulcerated, ulcerating, ulceration, ulcerative›breast

Code history

Unchanged in every release from FY2024 to FY2027.