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2025 ICD-10-CM code O91.1

Abscess of the breast associated with pregnancy, the puerperium, or lactation.

Codes from this chapter (O00-O9A) are for use only on maternal records, never on newborn records.Use additional codes to specify infection type and gestational week if applicable.

Medical necessity is established by the presence of a breast abscess causing significant pain, local inflammation, or systemic symptoms such as fever.Treatment is necessary to prevent spread of infection, potential sepsis, and improve patient comfort.

Obstetrician/Gynecologist, Family Physician, General Practitioner.May involve consultation with a surgeon for abscess management.

IMPORTANT:Use additional code to identify the infection.Consider codes from category Z3A (Weeks of gestation) to specify the gestational week, if known.

In simple words: This code is for a breast infection (abscess) that happens during pregnancy, after giving birth, or while breastfeeding. An abscess is a pocket of pus in the breast.

This code classifies an abscess of the breast that develops in connection with pregnancy, the postpartum period (puerperium), or breastfeeding (lactation).The abscess is a localized collection of pus within the breast tissue.It is a complication that can arise during these periods due to hormonal changes, immune system shifts, or from nipple trauma during breastfeeding.

Example 1: A 32-year-old woman, two weeks postpartum, presents with a painful, fluctuant mass in her right breast. Physical examination confirms a localized breast abscess.Cultures are pending., A 28-year-old lactating woman reports a painful, swollen area in her left breast, associated with fever and chills.Physical exam and ultrasound confirm a breast abscess. She is treated with antibiotics and incision and drainage., A 35-year-old woman in her third trimester of pregnancy develops a localized breast abscess.She is treated with antibiotics, and the abscess resolves without surgical intervention.

* Detailed history of present illness including onset, duration, and associated symptoms (pain, swelling, fever, chills).* Physical examination findings documenting the location, size, and characteristics of the breast mass.* Imaging studies (ultrasound, mammography if indicated) confirming the presence and extent of the abscess.* Microbiology results (culture and sensitivity) if an infectious etiology is suspected.* Treatment plan including antibiotics (if prescribed), incision and drainage (if performed), and follow-up care.

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