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  6. 2024 ICD-10-CM Code N64.81

2024 ICD-10-CM Diagnosis Code N64.81

Ptosis of breast

ICD-10-CM Code:
N64.81
ICD-10 Code for:
Ptosis of breast
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Chronic
Code Navigator:

Code Classification

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

N64.81 is a billable diagnosis code used to specify a medical diagnosis of ptosis of 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 N64.81 is applicable to adult patients aged 15 through 124 years inclusive. It is clinically and virtually impossible to use this code on a patient outside the stated age range.

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:

  • Bilateral ptotic breasts
  • Ptosis of left breast
  • Ptosis of right breast
  • Ptotic breast

Clinical Classification

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.


Type 1 Excludes

Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • ptosis of native breast in relation to reconstructed breast N65.1

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).

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

  • Adult diagnoses - The Medicare Code Editor detects inconsistencies in adult cases by checking a patient's age and any diagnosis on the patient's record. The adult code edits apply to patients age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).

Convert N64.81 to ICD-9-CM

  • ICD-9-CM Code: 611.81 - Ptosis of breast

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] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.