Is O91.01 a billable ICD-10-CM code?

No. O91.01 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does O91.01 sit in the tabular list?

Pregnancy, childbirth and the puerperium (O00-O9A), in the block Complications predominantly related to the puerperium (O85-O92).

O91.01

O91.01 — Infection of nipple associated with pregnancy

Non-billable headerICD-10-CM

O91.01 is a non-billable header ICD-10-CM code for infection of nipple associated with pregnancy. It cannot be billed on its own: choose one of the more specific child codes below.

Inclusion terms

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

Gestational abscess of nipple

Risk adjustment

O91.01 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 to one of these instead O91.01

4 child codes. Green means billable.

Related codes at this level

Codes that share O91.0. If O91.01 is not quite right, the correct code is usually one of these.

Questions about O91.01

Is O91.01 a billable ICD-10-CM code?: No. O91.01 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does O91.01 sit in the tabular list?: Pregnancy, childbirth and the puerperium (O00-O9A), in the block Complications predominantly related to the puerperium (O85-O92).