ICD-10-CM Billable Code

O91.213

Nonpurulent mastitis associated with pregnancy, third trimester

Clinical Classification Guidelines

Medical Intelligence & Overview

Nonpurulent mastitis during pregnancy, specifically in the third trimester, is an inflammation of the breast tissue that does not involve pus formation. This condition can cause discomfort and concern for expectant mothers. Recognized under the ICD-10 code O91.213, it is important to understand its causes, symptoms, diagnosis, and management to ensure proper care throughout pregnancy.

Causes & Symptoms

Clinical Causes: Hormonal changes during pregnancy leading to increased blood flow and breast tissue swelling. Breast duct blockage resulting from accumulated milk or secretions. Minor trauma or injury to the breast tissue. Localized infections without pus formation, possibly due to bacterial or other pathogens. Poor breast hygiene or skin irritation leading to inflammation. Stress and fatigue affecting immune response.

Key Symptoms: Breast tenderness or pain, often intensified in the third trimester. Swelling or hardening of breast tissue. Mild redness or warmth over the affected area. Feeling of fullness or heaviness in the breasts. Possible skin sensitivity or itching. No signs of pus, abscess, or systemic infection such as fever or chills.

Diagnostic & Treatment

Diagnosis Path: Medical history review focusing on pregnancy status and symptoms. Breast imaging such as ultrasound to evaluate tissue changes and differentiate from other conditions. Laboratory tests if an infection or other underlying issues are suspected. Exclusion of other breast conditions, including mastitis caused by bacteria, abscesses, or malignancy.

Treatment Protocols: Wearing well-fitting, supportive bras to minimize breast discomfort. Applying warm compresses to affected areas to reduce inflammation. Pain relief medications deemed safe during pregnancy, such as acetaminophen, if recommended by a healthcare professional. Maintaining good breast hygiene and skin care. Ensuring adequate hydration and rest. Monitoring symptoms closely; if signs of infection or abscess develop, further medical intervention may be needed. Follow-up with healthcare providers to track progress and address ongoing symptoms.

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 O91.213 a billable ICD-10 code?
Yes, O91.213 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report O91.213?
Clinical documentation must specify the nature of Nonpurulent mastitis associated with pregnancy, third trimester and any associated comorbidities for accurate reporting.

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Clinical Meta Tags

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