2025 ICD-10-CM code N61.2
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the genitourinary system - Disorders of breast Diseases of the genitourinary system (N00-N99) Feed
Granulomatous mastitis is a rare, chronic inflammatory breast condition.
Modifiers may be applicable depending on the specific circumstances of the encounter and the services provided.
Medical necessity for the diagnosis and treatment of granulomatous mastitis is established by the presence of clinical symptoms, imaging findings, and histopathological confirmation of granulomatous inflammation. Treatment may involve medical management or surgical intervention depending on the severity and progression of the disease.
Diagnosis and treatment of granulomatous mastitis fall under the responsibility of physicians specializing in breast health, such as obstetricians, gynecologists, or breast surgeons. The diagnostic process often involves imaging studies, biopsy, and potentially consultation with a pathologist.
In simple words: Granulomatous mastitis is an uncommon, long-lasting inflammation of the breast. It often comes back multiple times and can be difficult to diagnose and treat.It can affect one or both breasts.
Granulomatous mastitis is a rare, chronic inflammatory condition of the breast.It has a progressive clinical course with multiple recurrences and can present diagnostic and therapeutic challenges.The condition may affect one or both breasts. Specific codes exist to indicate the affected breast (right, left, bilateral, or unspecified).
Example 1: A 35-year-old female presents with a persistent, localized breast lump and inflammation.Biopsy reveals granulomatous inflammation, leading to a diagnosis of granulomatous mastitis of the right breast (N61.21)., A 42-year-old female with a history of recurrent breast inflammation undergoes imaging, revealing bilateral nodular masses consistent with granulomatous mastitis. A biopsy confirms the diagnosis, and code N61.23 is assigned., A 28-year-old female presents with breast pain and swelling. Imaging is inconclusive, but a biopsy shows granulomatous tissue, resulting in a diagnosis of unspecified breast location (N61.20).
Detailed clinical history including duration and progression of symptoms, physical examination findings noting location, size, and consistency of any masses, imaging reports (mammography, ultrasound, MRI), pathology report detailing the presence of granulomatous inflammation, and treatment plan.
** Granulomatous mastitis is a relatively rare condition, and accurate coding requires careful clinical documentation to distinguish it from other breast pathologies.The progressive nature of the disease and potential for recurrence should be documented to support medical necessity for ongoing care.
- Payment Status: Active
- Specialties:Obstetrics and Gynecology, Breast Surgery, Pathology
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center