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2025 ICD-10-CM code O92.1

Cracked nipple associated with pregnancy, the puerperium, and lactation.Fissure of nipple, gestational or puerperal.

This code is for use only on the maternal record, never on the newborn record.Use an additional code from category Z3A (Weeks of gestation) to identify the specific week of pregnancy if known.

Medical necessity for treatment of cracked nipples is established by the presence of pain, discomfort, or difficulty with breastfeeding, impacting the mother's ability to nourish her infant.

The clinician is responsible for accurately assessing the condition of the nipple, differentiating it from other breast disorders and infections, and providing appropriate management, which may include lactation counseling, topical treatments, pain management, and addressing any underlying causes.

IMPORTANT:For cracked nipple associated specifically with lactation, use O92.13.For infections of the nipple associated with childbirth (e.g., abscess), use O91.0. For other disorders of the breast associated with pregnancy and the puerperium, use O92.2.

In simple words: This code indicates cracked or sore nipples related to pregnancy, the time after delivery, or breastfeeding.

This code describes a cracked or fissured nipple that occurs during pregnancy, the postpartum period (puerperium), or while breastfeeding (lactation).It encompasses nipple fissures that arise due to hormonal changes, breastfeeding practices, or other factors associated with these periods.

Example 1: A pregnant woman in her third trimester presents with painful, cracked nipples.Examination reveals fissures on both nipples, likely due to hormonal changes and stretching of the skin. O92.1 is coded., A postpartum woman, two weeks after delivery, experiences severe nipple pain while breastfeeding.Examination reveals deep cracks in the nipples. O92.1 is coded., A woman who is exclusively breastfeeding her 5-month-old infant develops cracked and bleeding nipples. The physician diagnoses cracked nipples associated with lactation. O92.1 is coded.

Documentation should include a detailed description of the nipple condition, including location and severity of the cracks/fissures, associated symptoms (pain, bleeding), the presence or absence of infection, and any related factors such as breastfeeding practices. The trimester of pregnancy or time since delivery should be documented as applicable.

** This condition can significantly impact a woman's breastfeeding experience, and prompt treatment is important to promote successful lactation.

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