O92.1 — Cracked nipple associated with pregnancy, the puerperium, and lactation
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
Other codes that can never be billed with O92.1
These codes carry an Excludes1 note pointing at O92.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading O92.1 alone.
- Z39.1Encounter for care and examination of lactating mother
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 history
O92.1 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
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).