ICD-10-CM Billable Code

O91.11

Abscess of breast associated with pregnancy

Clinical Classification Guidelines

Inclusion Terms

  • Gestational mammary abscess
  • Gestational purulent mastitis
  • Gestational subareolar abscess

Medical Intelligence & Overview

An abscess of the breast associated with pregnancy, also known as gestational mammary abscess, is a localized infection that results in the collection of pus within breast tissue. This condition can cause discomfort and swelling, typically affecting women in the later stages of pregnancy. Recognized under ICD-10 code O91.11, this health issue requires attentive diagnosis and treatment to manage symptoms and prevent complications.

Causes & Symptoms

Clinical Causes: Blocked milk ducts leading to bacterial growth Bacterial infection from skin breaks or cracks in the nipple Poor breast hygiene during pregnancy Breast trauma or injury occurring during pregnancy Absence of prompt treatment of initial breast infections Conditions leading to immune suppression, increasing susceptibility to infection

Key Symptoms: Redness and swelling of the affected breast Localized pain or tenderness A palpable lump or abscess cavity Warmth in the affected area Fever and chills in some cases Discharge from the nipple, possibly containing pus General feelings of fatigue or unwellness

Diagnostic & Treatment

Diagnosis Path: Diagnosis is primarily based on clinical examination and medical history. Healthcare providers may perform the following assessments:

Treatment Protocols: Managing a gestational breast abscess involves several approaches, emphasizing safety for both mother and baby:

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

Clinical Advice & FAQs

Billing Guidance

Is O91.11 a billable ICD-10 code?
Yes, O91.11 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report O91.11?
Clinical documentation must specify the nature of Abscess of breast associated with pregnancy and any associated comorbidities for accurate reporting.

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