2025 ICD-10-CM code N63.3
(Active) Effective Date: N/A Diseases of the genitourinary system - Disorders of breast Diseases of the genitourinary system Feed
Unspecified lump in axillary tail.
The medical necessity for coding N63.3 is established when a lump is detected in the axillary tail of the breast and its nature is unclear requiring further investigation. The medical necessity for additional tests (imaging or biopsy) is dependent on the clinical context and physician judgment.Payment may be denied if adequate clinical documentation does not support the diagnostic code.
The clinical responsibility for code N63.3 includes performing a thorough physical examination of the breast and axilla, ordering and interpreting imaging studies (mammography, ultrasound), and potentially performing a biopsy to determine the nature of the lump.Further management depends on the diagnosis.
In simple words: This medical code is used when a doctor finds a lump in the armpit area that extends from the breast tissue, but they don't know if it's cancerous or not. More tests would be needed to figure out what the lump is.
N63.3 in the ICD-10-CM classification system codes for an unspecified lump located in the axillary tail of the breast.This code is used when a lump is found in the extension of breast tissue extending into the axilla (armpit) but the nature of the lump—benign or malignant—cannot be specified.
Example 1: A 45-year-old female presents with a painless lump in her right armpit.The lump is palpable but its characteristics are unclear.After a physical examination, mammography and ultrasound are ordered.N63.3 is used as the initial diagnosis pending further investigation., A 60-year-old female undergoes a routine mammogram, which reveals an abnormality in the upper outer quadrant of her left breast extending into the axilla.The abnormality is non-specific.N63.3 is assigned pending further assessment by ultrasound and possibly biopsy., A 32-year-old female discovers a small lump in her armpit. She is concerned about breast cancer.After a physical exam, the physician orders additional diagnostic imaging. N63.3 is assigned temporarily while tests such as an ultrasound or mammogram are conducted.
Detailed history of the lump (duration, symptoms, changes over time), results of physical examination, imaging studies (mammography, ultrasound, MRI if needed), biopsy report (if performed), and any other relevant clinical findings.
** This code is a placeholder until the nature of the lump is determined.Always ensure that sufficient clinical information supports the chosen code.
- Payment Status: Active
- Specialties:Surgery, Oncology, Radiology, Family Medicine
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center