2025 ICD-10-CM code N64.3
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the genitourinary system - Other disorders of breast XIV Diseases of the genitourinary system Feed
Galactorrhea not associated with childbirth.
Modifiers are not applicable to ICD-10-CM codes.
Medical necessity for evaluation of galactorrhea is established based on the symptoms impacting the patient’s well-being, potential underlying hormonal disorders or medication side effects that require medical intervention, and the need to distinguish from pathologic conditions.
The clinical responsibility for diagnosing and managing galactorrhea involves a thorough history, physical examination, and laboratory tests to identify the underlying cause. This may include assessing hormonal levels, evaluating pituitary function, and ruling out other medical conditions.
- XIV Diseases of the genitourinary system
- N60-N64 Disorders of breast > N64 Other disorders of breast
In simple words: This code is for women who have milk leaking from their breasts, but it's not because they've recently had a baby or are breastfeeding.
This ICD-10-CM code classifies galactorrhea, the spontaneous flow of milk from the breasts, that is not related to childbirth or breastfeeding.It encompasses the condition in adult women outside the postpartum period, and excludes galactorrhea occurring during pregnancy or lactation.
Example 1: A 35-year-old female presents with spontaneous milky discharge from both breasts, unrelated to pregnancy or breastfeeding.She reports no significant medical history.After a physical exam and hormonal testing, galactorrhea is diagnosed., A 42-year-old female with a history of hypothyroidism reports spontaneous breast milk leakage. She denies pregnancy or breastfeeding. Thyroid function tests reveal hypothyroidism.The galactorrhea is linked to her endocrine disorder., A 28-year-old female taking antipsychotic medication experiences unintended lactation.A thorough history reveals the medication as the likely cause of the galactorrhea.
Complete patient history including menstrual cycle, medications, and any recent pregnancies or breastfeeding history. Physical examination findings, noting the location and character of the discharge. Relevant laboratory test results, including hormonal levels and imaging studies as appropriate.
** This code should only be used when the galactorrhea is not associated with childbirth or breastfeeding.The underlying cause of the galactorrhea should be investigated and documented.
- Revenue Code: Revenue codes will vary based on the context of the visit and the services provided. Consult your specific payer guidelines for appropriate revenue codes.
- RVU: RVUs are not directly assigned to ICD-10 codes.Reimbursement is based on the procedures and services performed, coded with CPT or HCPCS codes, which then have associated RVUs for payment calculation.
- Global Days: Not applicable.ICD-10 codes do not have global periods; these are specific to surgical procedure coding (CPT).
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable.Fee schedules are associated with CPT and HCPCS codes, not ICD-10 codes.
- Specialties:Endocrinology, Gynecology
- Place of Service:Office, Hospital, Clinic