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Home/Diagnosis/ICD-10 Coding for Breast Reduction

ICD-10 Coding for Breast Reduction

N62
Z41.1

Complete ICD-10-CM coding and documentation guide for icd-10 coding for breast reduction includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Reduction Mammaplasty
Mammary Reduction
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Key Information: ICD-10 Coding for Breast Reduction

Essential facts and insights about ICD-10 Coding for Breast Reduction

Use ICD-10 code N62 for hypertrophy of breast, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Hypertrophy of breast

Billable Code
N62
Billable

Diagnostic Criteria

clinical:
  • • Presence of breast hypertrophy with associated symptoms
documentation:
  • • Documented failure of conservative treatments

Applicable To

  • • Macromastia

Important Notes

  • • Ensure documentation supports medical necessity to avoid cosmetic coding.

Encounter for cosmetic surgery

Billable Code
Z41.1
Billable

Important Notes

  • • Ensure cosmetic intent is clearly documented.
Ancillary Codes

Additional codes that may be used with this diagnosis

M54.6

Pain in thoracic spine

Use to document back pain associated with breast hypertrophy.

L30.4

Erythema intertrigo

Use for skin conditions like intertrigo caused by breast size.

Frequently Asked Questions

What is the ICD-10 code for breast reduction?

The ICD-10 code for medically necessary breast reduction is N62, indicating breast hypertrophy. For cosmetic procedures, use Z41.1.

When should N62 be used for breast reduction?

Use N62 when breast reduction is medically necessary due to symptoms like chronic pain or skin conditions linked to breast hypertrophy.

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