Version 2024

2024 ICD-10-CM Diagnosis Code N64.59

Other signs and symptoms in breast

ICD-10-CM Code:: N64.59
ICD-10 Code for:: Other signs and symptoms in breast
Is Billable?: Yes - Valid for Submission
Chronic Condition Indicator: ^[1]: Not chronic
Code Navigator:

Code Information
Approximate Synonyms
Clinical Classification
Tabular List of Diseases and Injuries
Index to Diseases and Injuries References
Diagnostic Related Groups Mapping
Convert to ICD-9 Code
Patient Education
Other Codes Used Similar Conditions
Code History

Code Classification

Diseases of the genitourinary system
(N00–N99)
- Disorders of breast
  (N60-N65)
  - Other disorders of breast
    (N64)

N64.59 is a billable diagnosis code used to specify a medical diagnosis of other signs and symptoms in breast. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

The code is commonly used in ob/gyn medical specialties to specify clinical concepts such as lump in breast and other disorders of the breast.

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

Absent nipple
Areolas unequal in size
Bilateral changes in skin of breasts
Bilateral inversion of nipple
Bleeding from breast
Bleeding from nipple
Bleeding of surface of nipple
Breast changes
Breast cold
Breast depigmented
Breast disc palpable
Breast hot
Breast hypopigmented
Breast pigmented
Breast signs and symptoms
Breast symptom of change in nipple
Breast symptom of change in skin
Breast temperature - finding
Breast temperature - finding
Breasts asymmetrical
Chest swelling
Complex sclerosing lesion of breast
Complex sclerosing lesion of left breast
Complex sclerosing lesion of right breast
Contour of breast distorted
Deformation of breast
Destructive lesion of nipple
Dimpling of surface of breast
Discoloration of nipple
Discoloration of skin of breast
Displacement of nipple
Edema of breast
Edema of nipple
Engorgement of breasts
Finding of color of breast
Finding of color of breast
Finding of color of breast
Finding of color of breast
Finding of color of breast
Finding of color of nipple
Finding of color of nipple
Finding of color of nipple
Finding of color of nipple
Finding of consistency of breast
Finding of flow of breast milk
Finding of measures of lactation
Finding of proportion of nipple
Finding of quantity of lactation
Finding of sensation of nipple
Flat nipple
Hair sinus
Hair sinus of breast
Increase in surface veins of breast
Induration of breast
Induration of breast
Induration of breast
Induration of left breast
Induration of right breast
Inversion of left nipple
Inversion of nipple
Inversion of right nipple
Lactiferous duct palpable
Lactiferous duct prominent
Lactiferous ducts finding
Lactiferous ducts finding
Large areola
Large nipple
Lesion of left nipple
Lesion of nipple
Lesion of right nipple
Milk leaking from breast
Nipple bleeding
Nipple deformity
Nipple deformity
Nipple deformity
Nipple deformity
Nipple depigmented
Nipple hypopigmented
Nipples unequal in size
Position of nipple - finding
Red breast
Red nipple
Retraction of skin of breast
Rippling of surface of breast associated with prosthetic breast implant
Shape of breasts unequal
Sinus of breast
Sinus of breast
Size of breast - finding
Size of breasts unequal
Size of nipple - finding
Size of nipple - finding
Small breast
Small nipple
Soft breast
Sore nipple
Surface characteristics of breast - finding
Surface characteristics of breast - finding
Surface characteristics of breast - finding
Swelling of breast
Swelling of nipple
Symmetry of breasts - finding
Symmetry of breasts - finding
Symmetry of breasts - finding
Thickening of skin
Thickening of skin of breast
Veins visible on breast
Wide spaced nipples

Clinical Classification

Clinical Category is Nonmalignant breast conditions
CCSR Category Code: GEN017
Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

- Bleeding - See Also: Hemorrhage;
- - nipple - N64.59

- Congestion, congestive
- - breast - N64.59

- Engorgement
- - breast - N64.59

- Hemorrhage, hemorrhagic (concealed) - R58
- - breast - N64.59
- - nipple - N64.59

- Inversion
- - nipple - N64.59

- Symptoms NEC - R68.89
- - breast NEC - N64.59

- Thickening
- - breast - N64.59

N64.59 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
600	NON-MALIGNANT BREAST DISORDERS WITH CC/MCC	09	1.0255
601	NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC	09	0.6226

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Convert N64.59 to ICD-9-CM

ICD-9-CM Code: 611.79 - Symptoms in breast NEC
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education

Breast Diseases

Most women experience breast changes at some time. Your age, hormone levels, and medicines you take may cause lumps, bumps, and discharges (fluids that are not breast milk).

If you have a breast lump, pain, discharge or skin irritation, see your health care provider. Minor and serious breast problems have similar symptoms. Although many women fear cancer, most breast problems are not cancer.

Some common breast changes are:

Fibrocystic breast changes - lumpiness, thickening and swelling, often just before a woman's period
Cysts - fluid-filled lumps
Fibroadenomas - solid, round, rubbery lumps that move easily when pushed, occurring most in younger women
Intraductal papillomas - growths similar to warts near the nipple
Blocked milk ducts
Milk production when a woman is not breastfeeding

NIH: National Cancer Institute

[Learn More in MedlinePlus]

Code History

FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.