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2025 ICD-10-CM code N61.20

Granulomatous mastitis, unspecified breast location.

Follow standard ICD-10-CM coding guidelines.If laterality is specified in the medical documentation, use the appropriate laterality codes (N61.21, N61.22, N61.23) instead of N61.20.

Medical necessity for diagnostic and therapeutic interventions related to granulomatous mastitis is established based on the presence of symptoms (pain, swelling, mass), imaging findings suggestive of inflammation, and confirmatory histopathological examination. Treatment is deemed medically necessary based on the severity of symptoms and the potential for complications.

The clinical responsibility for managing a patient with N61.20 involves a thorough history and physical examination, imaging studies (such as mammography and ultrasound) to evaluate the extent of the inflammation and rule out other conditions.A biopsy may be necessary for definitive diagnosis. Treatment plans can vary depending on the cause, severity, and response to treatment.This may include antibiotics, corticosteroids, or other medications. In some cases, surgical intervention might be necessary.

IMPORTANT:N61.21 (Granulomatous mastitis, right breast), N61.22 (Granulomatous mastitis, left breast), N61.23 (Granulomatous mastitis, bilateral breast) should be used if the laterality of the condition is known.

In simple words: This code describes a type of breast inflammation where small clumps of immune cells form in the breast.The exact location in the breast (right, left, or both) isn't specified.

This code is used to classify granulomatous mastitis, a type of breast inflammation characterized by the formation of granulomas (small clumps of immune cells).The "unspecified breast" designation indicates that the specific location (right, left, or bilateral) of the mastitis is not specified in the medical documentation.Granulomatous mastitis can be caused by various factors, including infections and autoimmune disorders.Accurate diagnosis often requires histological examination of breast tissue.

Example 1: A 45-year-old female presents with a palpable mass and localized breast pain. Mammography reveals an area of increased density, and a core needle biopsy confirms the presence of granulomatous mastitis., A 30-year-old female with a history of autoimmune disorders presents with bilateral breast tenderness and swelling. Imaging studies are suggestive of granulomatous mastitis, and a treatment plan involving corticosteroids is initiated., A 60-year-old female presents with a history of recurrent breast infections.Physical examination reveals indurated areas in the left breast. Biopsy reveals granulomatous mastitis which may require surgical intervention.

Complete medical history, physical examination findings, results of imaging studies (mammography, ultrasound), and pathology reports from tissue biopsy.Detailed documentation of treatment plan and response is also required.

** Granulomatous mastitis can be challenging to diagnose and treat.It's essential to differentiate it from other breast conditions, including malignancy.Proper documentation is crucial for accurate coding and reimbursement.

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