O91.13

O91.13: Abscess of breast associated with lactation

Billable / specific codeICD-10-CM

O91.13 is a billable, specific ICD-10-CM code for abscess of breast associated with lactation. It is valid for submission on a claim.

Check O91.13 with the rest of the claim: free scrubber

Inclusion terms

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

Mammary abscess associated with lactation
Purulent mastitis associated with lactation
Subareolar abscess associated with lactation

Other codes that can never be billed with O91.13

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

O91.13 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›associated with lactation
Puerperal, puerperium›abscess›mammary›associated with lactation
Puerperal, puerperium›abscess›subareolar›associated with lactation
Puerperal, puerperium›fistula›breast›associated with lactation
Puerperal, puerperium›mastitis›purulent›associated with lactation
Suppuration, suppurative›mammary gland›puerperal, postpartum›associated with lactation
Mastitis›obstetric›purulent›associated with›lactation

Code history

Unchanged in every release from FY2024 to FY2027.