2025 ICD-10-CM code O91.0
Infection of the nipple associated with pregnancy, childbirth, or the postpartum period (puerperium), including while breastfeeding.
Medical necessity is established by the presence of signs and symptoms of a nipple infection related to pregnancy, childbirth, or breastfeeding.Treatment is necessary to resolve the infection, prevent complications (e.g., abscess formation, mastitis), and support continued breastfeeding if desired.
The physician is responsible for diagnosing the infection, identifying any underlying causes, and prescribing appropriate treatment. This may involve culturing the infected area to determine the causative organism and guide antibiotic therapy.Supportive care, such as pain management and breastfeeding guidance, is also important.
- 15 Pregnancy, childbirth and the puerperium
- Complications predominantly related to the puerperium (O85-O92)
In simple words: Nipple infection related to pregnancy, childbirth, or breastfeeding.
Infection of the nipple associated with pregnancy, the puerperium and lactation.This includes conditions occurring during pregnancy, the puerperium (postpartum period), or lactation.
Example 1: A woman in her third trimester presents with a red, tender, and swollen nipple.Upon examination, a localized infection is diagnosed., A postpartum patient experiences pain and cracking of the nipple, followed by the development of a localized infection., A breastfeeding mother develops a fever and localized nipple pain.An abscess is found on examination.
Documentation should include the location and characteristics of the infection (e.g., redness, swelling, discharge), associated symptoms (e.g., pain, fever), and any diagnostic tests performed (e.g., culture, imaging studies).The relationship to pregnancy, puerperium, or lactation should also be clearly documented.
** This code applies to infections of the nipple itself.For infections involving the breast tissue (e.g., mastitis, breast abscess), use codes O91.1 or O91.2.
- Payment Status: Active
- Specialties:Obstetrics and Gynecology, Family Medicine, Lactation Consultants
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Home