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2025 ICD-10-CM code O92.2

Other and unspecified disorders of the breast associated with pregnancy and the puerperium.

Ensure that the code is used only for conditions directly related to pregnancy, childbirth, or the puerperium.Use additional codes, if applicable, to specify any associated complications or secondary diagnoses. Do not use this code for conditions unrelated to these states.

The medical necessity will depend on the specific symptoms and severity of the breast condition.Further evaluation and management might be necessary to determine if the condition is benign or warrants additional investigation, such as for malignancy.This would need to be clearly documented in the medical record.

Obstetrician-gynecologists, and potentially general practitioners or family physicians depending on the complexity and management of the breast condition.If surgical intervention is necessary, a surgeon may also be involved.

IMPORTANT:Consider other O92 codes (O92.0-O92.7) if a more specific breast or lactation disorder is identifiable.Codes from chapter F (Mental and Behavioral Disorders) or other chapters should be used for conditions not directly related to pregnancy, childbirth, or the puerperium.

In simple words: This code is used for any breast problems that happen during pregnancy or after childbirth that don't have a more specific medical code.Doctors use it when the exact problem is unknown or can't be easily defined.

This code encompasses various breast conditions not otherwise specified that develop during pregnancy or the postpartum period.It includes conditions affecting the breast's structure or function, excluding those with specific ICD-10 codes (like cracked or retracted nipples).The diagnosis should be clearly documented, specifying the precise breast condition and its relationship to pregnancy or the puerperium.

Example 1: A postpartum patient presents with breast pain and swelling, but no specific infection or abscess is identified. O92.2 would be used to code the unspecified breast disorder., A pregnant patient develops a breast mass of unknown etiology.After ruling out other diagnoses, O92.2 is assigned, pending further investigations., A patient experiences persistent nipple discharge postpartum, with no evident infection or underlying malignancy. Further investigation is needed, and this code is temporarily assigned.

Detailed clinical documentation including a thorough history and physical examination focusing on the breast. Relevant investigations such as imaging (mammography, ultrasound), cytology, and biopsy findings should be documented to support the diagnosis.The relationship between the breast condition and pregnancy/puerperium must be explicitly stated.

** This code should be used cautiously and only when a more specific code is not applicable.Always ensure that the diagnosis is clearly documented, and the link to the pregnancy or puerperium is well-established.

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