2025 ICD-10-CM code O91.22
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Obstetric Complications - Complications predominantly related to the puerperium (O85-O92) Chapter XV: Pregnancy, childbirth and the puerperium (O00-O99) Feed
Nonpurulent mastitis associated with the puerperium.
Modifiers may apply depending on the circumstances of service and the payer's specific rules.
Medical necessity is established by the presence of symptoms consistent with nonpurulent mastitis (pain, swelling, redness), confirmed clinically by examination. Further investigation may be warranted if signs of infection are present.
Obstetrician/Gynecologist, Family Medicine Physician
In simple words: This code is for breast inflammation (swelling and pain) that happens after childbirth and isn't caused by an infection with pus-forming bacteria.
This code classifies nonpurulent mastitis occurring during the puerperium (the period after childbirth).It specifically refers to inflammation of the breast tissue that is not caused by pus-forming bacteria.This condition can present with pain, swelling, redness, and tenderness in the breast.
Example 1: A 30-year-old woman, 2 weeks postpartum, presents with breast pain, swelling, and redness in her right breast.Physical examination reveals localized inflammation without purulent discharge.A diagnosis of puerperal nonpurulent mastitis is made., A 25-year-old woman, one month postpartum, reports breast discomfort and tenderness. Examination shows localized breast swelling and erythema, but no fluctuance or purulent drainage.The diagnosis is nonpurulent mastitis associated with the puerperium., A 35-year-old woman, experiencing breastfeeding difficulties, presents with unilateral breast pain and swelling without signs of infection.Clinical evaluation confirms nonpurulent mastitis, likely related to breastfeeding challenges in the postpartum period.
Complete patient history including pregnancy and delivery details, breastfeeding status (if applicable), physical examination findings (including assessment for signs of infection), diagnostic tests (if any).
** Differential diagnosis should exclude conditions such as mastitis caused by infectious agents (bacterial or fungal).Appropriate treatment includes supportive measures (analgesics, warm compresses) and, in some cases, antibiotics if a secondary infection develops.
- Payment Status: Active
- Specialties:Obstetrics and Gynecology, Family Medicine
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital