2025 ICD-10-CM code O92
Other disorders of breast and disorders of lactation associated with pregnancy and the puerperium.
Medical necessity must be established by documenting the impact of the breast or lactation disorder on the patient's health or ability to breastfeed. For example, cracked nipples or breast engorgement may interfere with breastfeeding and require interventions to prevent complications. Documentation about any treatments and patient education to resolve the disorder is required.
The physician is responsible to diagnose any disorders of the breasts and lactation during pregnancy and the postpartum period. If there is infection, it must be properly treated and documented as part of the overall postpartum care.
- 15 Pregnancy, childbirth and the puerperium
- O85-O92 Complications predominantly related to the puerperium
In simple words: This code covers other problems with breasts and breastfeeding that happen during or after pregnancy.
This code encompasses various breast and lactation disorders connected with pregnancy and the period following childbirth (puerperium), excluding those already classified elsewhere.It includes conditions like retracted nipple (O92.0), nipple crack and fissure (O92.1), breast engorgement (O92.2), other specified disorders of the breast (O92.3), and other and unspecified disorders of lactation (O92.7), among others.
Example 1: A patient 2 weeks postpartum presents with cracked nipples and difficulty breastfeeding. After examination, the physician diagnoses cracked nipple and fissure related to childbirth (O92.1). , A pregnant woman in her third trimester reports a retracted nipple, making it difficult for the baby to latch. This is diagnosed as retracted nipple associated with pregnancy (O92.0)., A patient in the puerperium experiences breast engorgement, pain and tenderness. This is documented as O92.2.
Detailed clinical documentation describing the specific breast or lactation disorder, its relationship to the pregnancy or puerperium, and any associated symptoms is essential.
** Do not use this code for newborn records.
- Payment Status: Active
- Specialties:Obstetrics, Family Medicine, Lactation Consultants
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Birthing Center