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2025 ICD-10-CM code N64.4

Mastodynia (breast pain).

Use additional codes to further specify the type and characteristics of breast pain, such as location, severity, and relationship to the menstrual cycle.Appropriate diagnostic testing should be documented.

Medical necessity is established when a patient experiences clinically significant breast pain that impairs their daily activities or quality of life.Further investigations are warranted if there is a suspicion of underlying pathology (e.g., malignancy, fibrocystic changes).

Diagnosis and management of breast pain, including assessment of potential underlying causes, pain management strategies, and patient education.Referral to specialists may be necessary depending on the severity and etiology of the pain.

IMPORTANT:May be used in conjunction with codes for other conditions a patient may have simultaneously (Type 2 Excludes note).Consider additional codes for specifying the type of breast pain (e.g., cyclical vs. non-cyclical) if more detail is needed.ICD-9-CM code 611.71 (Mastodynia) is an equivalent code.

In simple words: Breast pain, which may be related to a woman's menstrual cycle or not. The pain can range from mild discomfort to severe pain.

Mastodynia, also known as mastalgia, refers to pain in the breast.It can be cyclical (related to menstrual periods) or non-cyclical, originating from the breast tissue, adjacent muscles, or joints.The pain can range from mild discomfort to severe, debilitating pain.

Example 1: A 30-year-old female patient presents with cyclical breast pain worsening before her menses.Physical exam reveals tenderness to palpation bilaterally.The pain is managed with NSAIDs and reassurance., A 45-year-old female patient experiences persistent, non-cyclical breast pain localized to the upper outer quadrant of her right breast.Mammography and ultrasound are ordered to rule out malignancy., A 25-year-old female patient presents with severe breast pain after a recent breast augmentation surgery.The pain is treated with analgesics, and close monitoring is undertaken to assess healing progress.

Thorough history of presenting complaint, including pain character, location, onset, duration, aggravating and relieving factors, and menstrual cycle association.Physical examination documenting breast tenderness and masses.Imaging studies as clinically indicated (mammography, ultrasound).Pain management interventions and patient response.

** This code is primarily used for breast pain.It is crucial to document the clinical findings thoroughly, including any other associated symptoms and findings, to ensure appropriate coding and reimbursement.

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