O91.12
O91.12: Abscess of breast associated with the puerperium
Billable / specific codeICD-10-CM
O91.12 is a billable, specific ICD-10-CM code for abscess of breast associated with the puerperium. It is valid for submission on a claim.
Check O91.12 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Puerperal mammary abscess
- Puerperal purulent mastitis
- Puerperal subareolar abscess
Other codes that can never be billed with O91.12
Their own Excludes1 notes name this code, so the conflict is not listed above.
- N61Inflammatory disorders of breast
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
O91.12 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56766Billing and Coding: Incision and Drainage (I&D) of Abscess of Skin, Subcutaneous and Accessory Structures
Alphabetic index entries that lead here
- Puerperal, puerperium›abscess›breast
- Puerperal, puerperium›abscess›mammary
- Puerperal, puerperium›abscess›subareolar
- Puerperal, puerperium›fistula›breast(due to mastitis)
- Puerperal, puerperium›mastitis›purulent
- Suppuration, suppurative›mammary gland›puerperal, postpartum
- Mastitis›obstetric›purulent›associated with›puerperium
Code history
Unchanged in every release from FY2024 to FY2027.