2027 ICD-10-CM Diagnosis Code O92.13Cracked nipple associated with lactation

ICD-10-CM Codes›O00-O9A›O85-O92›O92

ICD-10-CM O92.13
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

O92.13 is a billable ICD-10-CM diagnosis code for cracked nipple associated with lactation. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 769, 776. The code is restricted by the Medicare Code Editor to maternity cases (age 9 through 64). Coders also document this condition as cracked nipple associated with childbirth. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Complications specified during the puerperium.

Code Identity

ICD-10-CM Code
O92.13
Billable Status
Yes — Valid for Submission
Code Describes
Cracked nipple associated with lactation
Short Description
Cracked nipple associated with lactation
Same as the full description in the CMS dataset.
Parent Code
O92.1
Cracked nipple associated with pregnancy, the puerperium, and lactation

Code Classification

ChapterO00-O9APregnancy, childbirth and the puerperium
SectionO85-O92Complications predominantly related to the puerperium
CategoryO92Other disorders of breast and disorders of lactation associated with pregnancy and the puerperium
This CodeO92.13Cracked nipple associated with lactation

Code EditsBilling

Medicare Code Editor checks that affect claim validity for O92.13.

Maternity diagnoses
The Medicare Code Editor detects inconsistencies in maternity cases by checking a patient's age and any diagnosis on the patient's record. The maternity code edits apply to patients age ange is 9–64 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Cracked nipple associated with childbirth
  • Cracked nipple associated with lactation
  • Cracked nipple in pregnancy, the puerperium or lactation
  • Fissure of left nipple
  • Fissure of left nipple during lactation
  • Fissure of right nipple
  • Fissure of right nipple during lactation
  • Lesion of left nipple
  • Lesion of right nipple
  • Postpartum cracked nipple

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to O92.13: its own notes plus those printed at 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.

From Chapter 15 (O00-O9A) Pregnancy, childbirth and the puerperium applies to 2,481 codes
  • 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.

From Block O85-O92 Complications predominantly related to the puerperium applies to 114 codes
  • mental and behavioral disorders associated with the puerperium (F53.-)
  • obstetrical tetanus (A34)
  • puerperal osteomalacia (M83.0)
From Chapter 15 (O00-O9A) Pregnancy, childbirth and the puerperium applies to 2,481 codes
  • mental and behavioral disorders associated with the puerperium (F53.-)
  • obstetrical tetanus (A34)
  • postpartum necrosis of pituitary gland (E23.0)
  • puerperal osteomalacia (M83.0)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Chapter 15 (O00-O9A) Pregnancy, childbirth and the puerperium applies to 2,481 codes
  • 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.

From Chapter 15 (O00-O9A) Pregnancy, childbirth and the puerperium applies to 2,481 codes
  • 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 O92.13, its category, or a range that includes it.

Excludes1 2

These codes carry an Excludes1 note naming O92.13: they are not reported together with it, unless the two conditions are unrelated.

  • Z39.1 Encounter for care and examination of lactating mother
    disorders of lactation (O92.-) names O92.-, which includes this code
  • Block N60-N65 Disorders of breast
    disorders of breast associated with childbirth (O91-O92) names O91-O92, which includes this code

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 PRG027
Complications specified during the puerperium
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 O92.13 to ICD-9-CMHistory

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

ICD-9-CM
676.12 Cracked nipple-del w p/p
Approximate The match is approximate rather than exact.
ICD-9-CM
676.14 Cracked nipple-postpart
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 O92.13Overview

What is the ICD-10 code for cracked nipple associated with lactation?

The ICD-10-CM code for cracked nipple associated with lactation is O92.13 (sometimes written as O9213). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is O92.13 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report cracked nipple associated with lactation on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does O92.13 group to?

When cracked nipple associated with lactation is the principal diagnosis on an inpatient stay, it groups to MS-DRG 769, 776, with relative weights from 0.6718 to 1.6666 depending on complications. Higher weights mean higher Medicare reimbursement.

Who can O92.13 be reported for?

The Medicare Code Editor checks cracked nipple associated with lactation against patient demographics: this code is intended for maternity cases (age 9 through 64). Claims outside these limits are flagged as inconsistent.

What is the ICD-9 equivalent of O92.13?

Under the General Equivalence Mappings, cracked nipple associated with lactation converts to ICD-9-CM 676.12 (cracked nipple-del w p/p) and 676.14 (cracked nipple-postpart). The mapping is approximate, so confirm the match fits the documentation.