2027 ICD-10-CM Diagnosis Code N64.0Fissure and fistula of nipple

ICD-10-CM Codes›N00–N99›N60-N65›N64

ICD-10-CM N64.0
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

N64.0 is a billable ICD-10-CM diagnosis code for fissure and fistula of nipple. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 600 through 601. Coders also document this condition as bilateral cracked nipples. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Nonmalignant breast conditions.

This medical diagnosis code is frequently used in OB/GYN medical specialties to designate conditions such lump in breast and other disorders of the breast.

Code Identity

ICD-10-CM Code
N64.0
Billable Status
Yes — Valid for Submission
Code Describes
Fissure and fistula of nipple
Short Description
Fissure and fistula of nipple
Same as the full description in the CMS dataset.
Parent Code
N64
Other disorders of breast

Code Classification

ChapterN00–N99Diseases of the genitourinary system
SectionN60-N65Disorders of breast
CategoryN64Other disorders of breast
This CodeN64.0Fissure and fistula of nipple

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Bilateral cracked nipples
  • Fissure and fistula of nipple
  • Fissure of left nipple
  • Fissure of nipple
  • Fissure of right nipple
  • Lesion of left nipple
  • Lesion of right nipple

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to N64.0: its own notes plus those printed at N64, block N60-N65, and Chapter 14. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From Block N60-N65 Disorders of breast applies to 60 codes
  • disorders of breast associated with childbirth (O91-O92)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From N64 Other disorders of breast applies to 13 codes
  • mechanical complication of breast prosthesis and implant (T85.4-)
From Chapter 14 (N00-N99) Diseases of the genitourinary system applies to 838 codes
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR GEN017
Nonmalignant breast conditions
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Breast Diseases

Breast diseases include various conditions and changes in your breast. Most women experience breast changes at some time. Your age, hormone levels, and medicines you take may cause lumps, bumps, and discharges of fluids that are not breast milk.

The full article covers:

  • What are breast diseases?
  • What are the symptoms of breast disease?
  • How are breast diseases diagnosed?
  • What are the treatments for breast disease?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert N64.0 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
611.2 Fissure of nipple
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About N64.0Overview

What is the ICD-10 code for fissure and fistula of nipple?

The ICD-10-CM code for fissure and fistula of nipple is N64.0 (sometimes written as N640). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is N64.0 (Other disorders of breast) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report fissure and fistula of nipple on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does N64.0 group to?

When fissure and fistula of nipple is the principal diagnosis on an inpatient stay, it groups to MS-DRG 600, 601, with relative weights from 0.6014 to 0.9971 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of N64.0?

Under the General Equivalence Mappings, fissure and fistula of nipple converts to ICD-9-CM 611.2 (fissure of nipple). The mapping is approximate, so confirm the match fits the documentation.