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Home/Diagnosis/ICD-10 Coding for Lump in Breast

ICD-10 Coding for Lump in Breast

N63.12
N63.15

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

Also Known as:
Breast Mass
Breast Lump
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Key Information: ICD-10 Coding for Lump in Breast

Essential facts and insights about ICD-10 Coding for Lump in Breast

Use ICD-10 code N63.12 for unspecified lump in the right breast, upper inner quadrant, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Unspecified lump in the right breast, upper inner quadrant

Billable Code
N63.12
Billable

Diagnostic Criteria

documentation_criteria:
  • • Presence of lump in specified quadrant and laterality
applicable_to:
  • • Palpable mass at 2 o'clock position, right breast
excludes:
  • • Malignant neoplasm of breast (C50.911)
validation:
  • • Documentation of lump location at 2 o'clock in the right breast
  • • Imaging reports confirming lump in specified quadrant
notes:
  • • Ensure quadrant and laterality are documented to avoid unspecified coding.
risks:
  • • Risk of using unspecified codes if quadrant is not documented.

Unspecified lump in the right breast, overlapping quadrants

Billable Code
N63.15
Billable

Diagnostic Criteria

applicable_to:
  • • Mass at 6 o'clock extending to lower inner/outer quadrants
excludes:
  • • Malignant neoplasm of breast (C50.911)
validation:
  • • Documentation of lump spanning multiple quadrants
  • • Imaging reports confirming overlapping quadrant involvement
notes:
  • • Ensure documentation clearly indicates overlapping quadrants.
Ancillary Codes

Additional codes that may be used with this diagnosis

R92.1

Mammographic microcalcification found on diagnostic imaging of breast

Use when imaging shows microcalcifications that require further investigation.

Frequently Asked Questions

How do you code a lump in the breast?

Use ICD-10 code N63.1x for unspecified lumps in the breast, specifying laterality and quadrant for accuracy.

What is the ICD-10 code for a breast lump?

The ICD-10 code for a breast lump is N63, with specific codes for laterality and quadrant.

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