Valid for Submission
N64.1 is a billable diagnosis code used to specify a medical diagnosis of fat necrosis of breast. The code N64.1 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
The ICD-10-CM code N64.1 might also be used to specify conditions or terms like bilateral fat necrosis of breasts, fat necrosis of breast, fat necrosis of left breast or fat necrosis of right breast.
The code N64.1 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.
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.
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code N64.1:
Inclusion TermsInclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- Fat necrosis (segmental) of breast
Code FirstCode First
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
- breast necrosis due to breast graft T85.898
Index to Diseases and Injuries
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code N64.1 are found in the index:
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Bilateral fat necrosis of breasts
- Fat necrosis of breast
- Fat necrosis of left breast
- Fat necrosis of right breast
Diagnostic Related Groups - MS-DRG Mapping
|MS-DRG||MS-DRG Title||MCD||Relative Weight|
|600||NON-MALIGNANT BREAST DISORDERS WITH CC/MCC||09||0.9957|
|601||NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC||09||0.6876|
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 N64.1 to ICD-9 Code
Information for Patients
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
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