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N64.4

N64.4: Mastodynia

Billable / specific codeICD-10-CM

N64.4 is a billable, specific ICD-10-CM code for mastodynia. It is valid for submission on a claim.

Check N64.4 with the rest of the claim: free scrubber

Excludes2 inherited from the categories above N64.4

Not part of this code, but both may be coded when both are present.

Written on N64: Other disorders of breast

  • mechanical complication of breast prosthesis and implant (T85.4-)

Other codes that can never be billed with N64.4

Their own Excludes1 notes name this code, so the conflict is not listed above.

  • R52Pain, unspecified

Risk adjustment

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

Medicare coverage

N64.4 is named in 9 Medicare coverage policies: 9 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
  • A53065Billing and Coding: Outpatient Physical Therapy
  • A56448Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
  • A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax

Alphabetic index entries that lead here

  • Mastalgia
  • Mastodynia
  • Pain›breast

Code history

Unchanged in every release from FY2024 to FY2027.

Other codes under N64

ICD-10-CMFY2027· effective October 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release: see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.