ICD-10-CM Billable Code

O91.211

Nonpurulent mastitis associated with pregnancy, first trimester

Clinical Classification Guidelines

Medical Intelligence & Overview

Nonpurulent mastitis during the first trimester of pregnancy is a condition characterized by inflammation of the breast tissue without the presence of pus or bacterial infection. It commonly occurs as hormonal changes influence breast tissue, leading to discomfort, swelling, and tenderness. Recognizing the signs and understanding the condition can help pregnant women manage symptoms effectively and seek appropriate care when needed.

Causes & Symptoms

Clinical Causes: Hormonal fluctuations during early pregnancy, especially increased estrogen and progesterone levels. Enhanced blood flow to breast tissue preparing for milk production. Mechanical factors such as breast engorgement or tight clothing causing irritation. Minor injuries or skin irritations that may provoke inflammation without infection.

Key Symptoms: Breast tenderness or soreness Swelling and fullness of the breast tissue Warmth or mild redness over the affected area General discomfort or aching sensation in the breasts Possible skin changes such as softening or slight redness

Diagnostic & Treatment

Diagnosis Path: Diagnosis primarily involves clinical evaluation by a healthcare provider, including a physical examination of the breasts. The provider will assess symptoms and look for signs of inflammation. In some cases, imaging studies like ultrasound may be performed to rule out other conditions such as abscesses or mastitis caused by infection. Laboratory tests are generally not necessary unless an infection is suspected or other complications are present.

Treatment Protocols: Management of nonpurulent mastitis in pregnancy focuses on relieving symptoms and supporting comfort. Common approaches include:

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 O91.211 a billable ICD-10 code?
Yes, O91.211 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report O91.211?
Clinical documentation must specify the nature of Nonpurulent mastitis associated with pregnancy, first trimester and any associated comorbidities for accurate reporting.

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Clinical Meta Tags

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