O91.111
O91.111 — Abscess of breast associated with pregnancy, first trimester
Billable / specific codeICD-10-CM
O91.111 is a billable, specific ICD-10-CM code for abscess of breast associated with pregnancy, first trimester. It is valid for submission on a claim.
Risk adjustment
O91.111 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
O91.111 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.
- A56766Billing and Coding: Incision and Drainage (I&D) of Abscess of Skin, Subcutaneous and Accessory Structures
Related codes at this level
Codes that share O91.11. If O91.111 is not quite right, the correct code is usually one of these.
Questions about O91.111
- Is O91.111 a billable ICD-10-CM code?
- Yes. O91.111 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does O91.111 sit in the tabular list?
- Pregnancy, childbirth and the puerperium (O00-O9A), in the block Complications predominantly related to the puerperium (O85-O92).