2025 ICD-10-CM code N64.0
(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 Feed
Fissure and fistula of the nipple.
Unknown
Medical necessity for treatment of N64.0 would be established by the presence of symptoms affecting the patient’s well-being and requiring medical intervention. This may include pain management, infection control, or surgical repair of the fissure or fistula, depending on severity and response to conservative treatment.
The clinical responsibility for diagnosing and managing N64.0 would typically fall on a physician specializing in breast health, such as a general surgeon, breast surgeon, or gynecologist.Depending on the underlying cause, other specialists might be involved.
In simple words: This code describes a problem with the nipple, either a crack or a small abnormal tunnel. This can be caused by injury, infection, or an extra duct forming. It might be painful, bleed, or leak fluid.
N64.0, Fissure and fistula of the nipple, refers to a condition involving a crack or tear (fissure) or an abnormal passage (fistula) in the nipple.This can result from various factors, including inflammation, injury, or the formation of an extra duct between the mammary gland and the nipple. Symptoms may include pain, bleeding, weeping, or itching around the nipple. The breast is composed of fatty tissue, connective tissue, and the mammary gland, which produces milk during and after pregnancy. Milk is expressed through the nipple, which is composed of multiple individual glands that open into small ducts converging at the nipple.
Example 1: A breastfeeding mother develops a painful, cracked nipple (fissure) due to improper latch., A patient presents with a persistent, draining fistula near the nipple, possibly related to a previous infection or injury., A patient experiences nipple pain and discharge with an identified abnormal duct (fistula) during a routine breast examination.
Detailed patient history including symptoms (pain, bleeding, discharge), onset, duration, and any relevant past medical history or trauma. Physical examination findings detailing the location and characteristics of the fissure or fistula.Imaging studies (e.g., ultrasound, mammography) might be needed to assess the extent of the condition.Laboratory tests (e.g., cultures) to rule out infection.
** Further investigation may be needed to determine the underlying cause and appropriate treatment for the fissure or fistula.Additional codes may be necessary to fully capture the clinical picture, such as codes related to infection, trauma, or other associated conditions.The severity and extent of the condition may affect treatment decisions and associated billing.
- Revenue Code: Unknown
- RVU: Unknown
- Global Days: Not applicable
- Payment Status: Active
- Modifier TC rule: Not applicable
- Fee Schedule: Unknown
- Specialties:General Surgery, Breast Surgery, Gynecology
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center