O91.213
O91.213 — Nonpurulent mastitis associated with pregnancy, third trimester
Billable / specific codeICD-10-CM
O91.213 is a billable, specific ICD-10-CM code for nonpurulent mastitis associated with pregnancy, third trimester. It is valid for submission on a claim.
Risk adjustment
O91.213 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
O91.213 is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56587Billing and Coding: Cosmetic and Reconstructive Surgery
- A58573Billing and Coding: Cosmetic and Reconstructive Surgery
- A58774Billing and Coding: Cosmetic and Reconstructive Surgery
- A59299Billing and Coding: Cosmetic and Reconstructive Surgery
Related codes at this level
Codes that share O91.21. If O91.213 is not quite right, the correct code is usually one of these.
Questions about O91.213
- Is O91.213 a billable ICD-10-CM code?
- Yes. O91.213 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does O91.213 sit in the tabular list?
- Pregnancy, childbirth and the puerperium (O00-O9A), in the block Complications predominantly related to the puerperium (O85-O92).