Is O92.1 a billable ICD-10-CM code?

No. O92.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does O92.1 sit in the tabular list?

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

O92.1

O92.1 — Cracked nipple associated with pregnancy, the puerperium, and lactation

Non-billable headerICD-10-CM

O92.1 is a non-billable header ICD-10-CM code for cracked nipple associated with pregnancy, the puerperium, and lactation. 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.

Fissure of nipple, gestational or puerperal

Risk adjustment

O92.1 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 O92.1

3 child codes. Green means billable.

Related codes at this level

Codes that share O92. If O92.1 is not quite right, the correct code is usually one of these.

Questions about O92.1

Is O92.1 a billable ICD-10-CM code?: No. O92.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does O92.1 sit in the tabular list?: Pregnancy, childbirth and the puerperium (O00-O9A), in the block Complications predominantly related to the puerperium (O85-O92).