N61.21
N61.21 — Granulomatous mastitis, right breast
Billable / specific codeICD-10-CMright
N61.21 is a billable, specific ICD-10-CM code for granulomatous mastitis, right breast. It is valid for submission on a claim.
Risk adjustment
N61.21 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.
Medicare coverage
N61.21 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56448Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Related codes at this level
Codes that share N61.2. If N61.21 is not quite right, the correct code is usually one of these.
Questions about N61.21
- Is N61.21 a billable ICD-10-CM code?
- Yes. N61.21 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does N61.21 sit in the tabular list?
- Diseases of the genitourinary system (N00-N99), in the block Disorders of breast (N60-N65).