Is ICD-10-CM code N61 billable?

No, N61 (Inflammatory disorders of breast) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code N61 belong to?

N61 belongs to Chapter 14 of the ICD-10-CM tabular list: N00–N99 (Diseases of the Genitourinary System).

N61Not billable, use a more specific code below

Inflammatory disorders of breast

In Disorders of breast (N60-N65), chapter 14: Diseases of the Genitourinary System

6 billable codes under N61: none are a CC or MCC; none map to an HCC.

Instructional notes

Excludes1: not coded here, use a different code

inflammatory carcinoma of breast (C50.A-)
inflammatory disorder of breast associated with childbirth (O91.-)
neonatal infective mastitis (P39.0)
thrombophlebitis of breast [Mondor's disease] (I80.8)

Also applies, from Disorders of breast (N60-N65)

These notes sit on N60-N65 and apply to every code under it, including N61.

Excludes1: not coded here, use a different code

disorders of breast associated with childbirth (O91-O92)

All codes under N61

N61 can't be used on a claim. Pick a billable code below; grey headings group them.

MS-DRGs

As the principal diagnosis, all 6 billable codes under N61 group to these MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Breast Diseases

Breast diseases include various conditions and changes in your breast. Most women experience breast changes at some time. Your age, hormone levels, and medicines you take may cause lumps, bumps, and discharges of fluids that are not breast milk.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015.

FY2017: Subcodes were added, so N61 is no longer billable on its own. New codes for cases coded here before: N61.0 (Mastitis without abscess), N61.1 (Abscess of the breast and nipple).

ICD-9-CM equivalent

Legacy crosswalk from the CMS General Equivalence Mappings (last updated 2018).

611.0 Inflammatory disease of breast

ICD-9 to ICD-10 converter