2027 ICD-10-CM Diagnosis Code O91.019Infection of nipple associated with pregnancy, unspecified trimester
ICD-10-CM Codes›O00-O9A›O85-O92›O91
- Billable — Valid for Submission
- Not Chronic
O91.019 is a billable ICD-10-CM diagnosis code for infection of nipple associated with pregnancy, unspecified trimester. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 817 through 819, 831 through 833. The code is restricted by the Medicare Code Editor to maternity cases (age 9 through 64). In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Nonmalignant breast conditions and Other specified complications in pregnancy.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for O91.019.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to O91.019: its own notes plus those printed at O91, block O85-O92, and Chapter 15. 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.
- supervision of normal pregnancy (Z34.-)
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.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code to identify infection
- code, if applicable, from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.
Notes
General instructions on how these codes are used.
- CODES FROM THIS CHAPTER ARE FOR USE ONLY ON MATERNAL RECORDS, NEVER ON NEWBORN RECORDS
- Codes from this chapter are for use for conditions related to or aggravated by the pregnancy, childbirth, or by the puerperium (maternal causes or obstetric causes)
- Trimesters are counted from the first day of the last menstrual period. They are defined as follows:
- 1st trimester- less than 14 weeks 0 days
- 2nd trimester- 14 weeks 0 days to less than 28 weeks 0 days
- 3rd trimester- 28 weeks 0 days until delivery
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name O91.019, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming O91.019: they are not reported together with it, unless the two conditions are unrelated.
- N61 Inflammatory disorders of breastinflammatory disorder of breast associated with childbirth (O91.-) names O91.-, which includes this code
- Block N60-N65 Disorders of breast
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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 O91.019 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About O91.019Overview
What is the ICD-10 code for infection of nipple associated with pregnancy, unspecified trimester?
The ICD-10-CM code for infection of nipple associated with pregnancy, unspecified trimester is O91.019 (sometimes written as O91019). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is O91.019 (Infection of nipple associated with pregnancy) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report infection of nipple associated with pregnancy, unspecified trimester on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does O91.019 group to?
When infection of nipple associated with pregnancy, unspecified trimester is the principal diagnosis on an inpatient stay, it groups to MS-DRG 833, 832, 831, 819, 818, 817, with relative weights from 0.5000 to 1.7586 depending on complications. Higher weights mean higher Medicare reimbursement.
Who can O91.019 be reported for?
The Medicare Code Editor checks infection of nipple associated with pregnancy, unspecified trimester against patient demographics: this code is intended for maternity cases (age 9 through 64). Claims outside these limits are flagged as inconsistent.
Does O91.019 need an additional code?
When the condition applies, yes. The Use Additional Code note at O91, which applies to O91.019, reads: code to identify infection. The additional code is reported after O91.019.
