Is N61.2 a billable ICD-10-CM code?

No. N61.2 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does N61.2 sit in the tabular list?

Diseases of the genitourinary system (N00-N99), in the block Disorders of breast (N60-N65).

What cannot be coded together with N61.2?

N61.2 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above N61.2 (N61) and apply to it just the same.

N61.2

N61.2 — Granulomatous mastitis

Non-billable headerICD-10-CM

N61.2 is a non-billable header ICD-10-CM code for granulomatous mastitis. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 inherited from the categories above N61.2

These are not written on N61.2, but they bind it: a note on a category applies to every code beneath it. Billing N61.2 with anything listed here is a denial.

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

N61.2 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code history

N61.2 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead N61.2

4 child codes. Green means billable.

Related codes at this level

Codes that share N61. If N61.2 is not quite right, the correct code is usually one of these.

Questions about N61.2

Is N61.2 a billable ICD-10-CM code?: No. N61.2 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does N61.2 sit in the tabular list?: Diseases of the genitourinary system (N00-N99), in the block Disorders of breast (N60-N65).
What cannot be coded together with N61.2?: N61.2 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above N61.2 (N61) and apply to it just the same.