2025 ICD-10-CM code O92.5
(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 18: Pregnancy, childbirth and the puerperium Feed
Suppressed lactation, also known as agalactia, is the absence or significant reduction of breast milk production after childbirth.
Modifiers might be applicable to other codes used in conjunction with O92.5 to indicate specific circumstances of service, such as the place of service or the type of professional providing the care, but not directly to O92.5 itself.
Medical necessity is generally not a concern for suppressed lactation unless there's an underlying medical condition requiring treatment or intervention to address the cause of the suppressed milk production.Documentation should justify any interventions or treatments aimed at improving milk production if applicable.
Obstetricians and gynecologists typically manage cases of suppressed lactation.Depending on the underlying cause, consultation with other specialists (e.g., endocrinologists, lactation consultants) may be necessary.
In simple words: This code means a mother is not producing enough breast milk after giving birth.There are different reasons why this might happen, including choosing not to breastfeed, having a medical condition that affects milk production, or being treated with medication that reduces milk supply.
O92.5, Suppressed lactation, in ICD-10-CM refers to the insufficient production of breast milk following childbirth. This can be categorized as elective agalactia (purposefully suppressed), secondary agalactia (resulting from underlying conditions), or therapeutic agalactia (intentionally reduced for medical reasons).The code excludes primary agalactia (O92.3), which is the inability to produce breast milk due to inherent physiological factors.
Example 1: A mother chooses not to breastfeed and actively suppresses lactation using medication or other methods., A mother experiences postpartum depression, leading to suppressed milk production due to psychological stress and hormonal imbalances., A mother undergoes surgery or medication that affects hormone production resulting in a significant decrease in milk supply.
Detailed medical history, including obstetrical history and any medications or treatments received.Physical examination findings, including assessment of breast tissue and milk production.Laboratory results relevant to hormonal levels, thyroid function, and other potential contributing factors.Patient's statement regarding breastfeeding attempts, challenges, and any use of lactation-suppressing methods.
** Suppressed lactation can have various causes; proper documentation of the clinical circumstances is essential for accurate coding.If the suppressed lactation is due to medication, record appropriate medication codes. Note that this code is for use only on maternal records.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Obstetrics and Gynecology
- Place of Service:Office, Hospital (Inpatient or Outpatient), Home