2025 ICD-10-CM code O92.13
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Complications predominantly related to the puerperium - Other disorders of breast and disorders of lactation associated with pregnancy and the puerperium Chapter 15: Pregnancy, childbirth and the puerperium Feed
Cracked nipple associated with lactation.
Medical necessity is established by the presence of symptomatic cracked nipples interfering with breastfeeding. Documentation should support the diagnosis and justify the interventions provided to alleviate the pain and enable continued breastfeeding if desired.
Obstetricians, gynecologists, family physicians, and other healthcare professionals involved in women's health may encounter and code this condition.The clinical responsibility includes diagnosis, treatment planning (e.g., recommending breastfeeding techniques, topical creams, or temporary cessation of breastfeeding), and follow-up care.
- Chapter 15: Pregnancy, childbirth and the puerperium
- O92.13 falls under the broader category O92 (Other disorders of breast and disorders of lactation associated with pregnancy and the puerperium) within Chapter 15 (Pregnancy, childbirth and the puerperium).
In simple words: This code is for a breastfeeding mother who has cracked or sore nipples.
This code signifies a cracked nipple specifically related to breastfeeding.It is used to classify a fissure or crack in the nipple of a breastfeeding mother, resulting from the act of breastfeeding itself.
Example 1: A 28-year-old primipara (first-time mother) presents with painful, cracked nipples 2 weeks postpartum. She is breastfeeding exclusively. The physician diagnoses cracked nipples associated with lactation (O92.13) and recommends lanolin cream and proper latch techniques., A 35-year-old multipara (mother who has delivered more than once) complains of cracked nipples and pain while breastfeeding her 6-week-old infant.She's experiencing some bleeding and a slight infection around the cracks.The physician diagnoses O92.13 and a secondary code for nipple infection (O91.03)., A 25-year-old breastfeeding mother experiences severe cracked and bleeding nipples due to improper latch. The physician recommends using breast shields and adjusting the baby's latch, along with treatment for pain and the cracks. They diagnose O92.13 and provide additional counseling.
Detailed patient history, including onset of symptoms, breastfeeding frequency and duration, pain level, description of nipple condition (e.g., presence of fissures, bleeding, infection), and response to treatment. Examination of the breasts and nipples should be well documented.Include details on any interventions (e.g., latch adjustment, cream application, breast shields).
** This code is specifically for cracked nipples associated with lactation.It should not be used if the cracked nipples are due to other causes.
- Payment Status: Active
- Specialties:Obstetrics, Gynecology, Family Medicine
- Place of Service:Office, Outpatient Hospital, Birthing Center