ICD-10-CM Code For Other Disorders Of Breast: Group Overview

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group N64 includes a variety of nonneoplastic breast conditions such as mastitis, galactorrhea, breast engorgement, and other inflammatory and structural breast disorders that affect breast tissue and associated ducts. These ICD-10-CM diagnosis codes are used to document clinical encounters involving symptoms like breast pain, discharge, swelling, or chronic inflammatory changes, capturing disease severity and anatomic involvement when applicable. Accurate coding within the ICD-10-CM N64 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

Customize your policy alerts

Sign up for ICD-10-CM Code For Other Disorders Of Breast: Group Overview policy alerts

Get alerted when relevant policies change without checking for updates manually.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

ICD-10-CM N64: Other Disorders Of Breast Overview

The ICD-10-CM N64 group represents a range of nonneoplastic disorders of the breast, including inflammatory, structural, and functional conditions affecting breast tissue. These diagnoses target breast anatomy and related soft tissues and can reflect symptoms such as pain, discharge, or enlargement. Accurate coding is important for complete clinical documentation and appropriate reimbursement for services related to breast care.

When to Use

Use a code from this group when the clinical documentation identifies a nonneoplastic breast condition as the reason for the encounter, such as inflammation, discharge, or pain localized to the breast. Select the most specific code that reflects the documented diagnosis, laterality, and any associated complications when available.

ICD-10-CM Codes

13 rows

ICD-10-CM Code	Description
N64.0	Fissure and fistula of nipple
N64.1	Fat necrosis of breast
N64.2	Atrophy of breast
N64.3	Galactorrhea not associated with childbirth
N64.4	Mastodynia
N64.51	Induration of breast
N64.52	Nipple discharge
N64.53	Retraction of nipple
N64.59	Other signs and symptoms in breast
N64.81	Ptosis of breast
N64.82	Hypoplasia of breast
N64.89	Other specified disorders of breast
N64.9	Disorder of breast, unspecified

DRG Codes

2 rows

DRG Code	Description
600	Non-Malignant Breast Disorders with CC/MCC
601	Non-Malignant Breast Disorders without CC/MCC

Typical Clinical Scenarios

A woman in her 30s presents to primary care with unilateral breast pain and palpable nodularity that worsens cyclically with her menstrual cycle; physical exam shows diffuse fibrocystic changes without discrete mass and ultrasound confirms multiple simple cysts and fibrous changes. A diagnosis from this group is assigned to describe benign fibrocystic breast disease causing pain and nodularity. Typical codes: N64.3, N64.4
A postmenopausal patient reports persistent unilateral nipple discharge that is serous and bloody; evaluation with nipple discharge cytology and duct excision reveals intraductal papilloma and chronic nipple retraction. A code from this group is used to capture the abnormal nipple findings and discharge as the reason for the diagnostic procedure. Typical codes: N64.0, N64.1, N64.2
A lactating patient develops a localized tender, fluctuant area of the breast with overlying erythema and is diagnosed with galactocele complicated by secondary infection after incision and drainage, requiring follow-up for nonhealing draining sinus. A diagnosis from this group documents the cystic milk retention and related complications of the breast. Typical codes: N64.51, N64.59

Related Codes

N60-BENIGN-MAMMARY-DYSPLASIA

ICD-10-CM Code For Benign Mammary Dysplasia: Group Overview

N61-INFLAMMATORY-DISORDERS-OF-BREAST

ICD-10-CM Code For Inflammatory Disorders Of Breast: Group Overview

N62-HYPERTROPHY-OF-BREAST

ICD-10-CM Code For Hypertrophy Of Breast: Group Overview

N63-UNSPECIFIED-LUMP-IN-BREAST

ICD-10-CM Code For Unspecified Lump In Breast: Group Overview

N65-DEFORMITY-AND-DISPROPORTION-RECONSTRUCTED-BREAST

ICD-10-CM Code For Deformity And Disproportion Of Reconstructed Breast: Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Explore openpayer tools

View all tools

When to Use

ICD-10-CM Codes

13 rows

ICD-10-CM Code	Description
N64.0	Fissure and fistula of nipple
N64.1	Fat necrosis of breast
N64.2	Atrophy of breast
N64.3	Galactorrhea not associated with childbirth
N64.4	Mastodynia
N64.51	Induration of breast
N64.52	Nipple discharge
N64.53	Retraction of nipple
N64.59	Other signs and symptoms in breast
N64.81	Ptosis of breast
N64.82	Hypoplasia of breast
N64.89	Other specified disorders of breast
N64.9	Disorder of breast, unspecified

DRG Codes

2 rows

DRG Code	Description
600	Non-Malignant Breast Disorders with CC/MCC
601	Non-Malignant Breast Disorders without CC/MCC

Typical Clinical Scenarios

A woman in her 30s presents to primary care with unilateral breast pain and palpable nodularity that worsens cyclically with her menstrual cycle; physical exam shows diffuse fibrocystic changes without discrete mass and ultrasound confirms multiple simple cysts and fibrous changes. A diagnosis from this group is assigned to describe benign fibrocystic breast disease causing pain and nodularity. Typical codes: N64.3, N64.4
A postmenopausal patient reports persistent unilateral nipple discharge that is serous and bloody; evaluation with nipple discharge cytology and duct excision reveals intraductal papilloma and chronic nipple retraction. A code from this group is used to capture the abnormal nipple findings and discharge as the reason for the diagnostic procedure. Typical codes: N64.0, N64.1, N64.2
A lactating patient develops a localized tender, fluctuant area of the breast with overlying erythema and is diagnosed with galactocele complicated by secondary infection after incision and drainage, requiring follow-up for nonhealing draining sinus. A diagnosis from this group documents the cystic milk retention and related complications of the breast. Typical codes: N64.51, N64.59

Related Codes

N60-BENIGN-MAMMARY-DYSPLASIA

ICD-10-CM Code For Benign Mammary Dysplasia: Group Overview

N61-INFLAMMATORY-DISORDERS-OF-BREAST

ICD-10-CM Code For Inflammatory Disorders Of Breast: Group Overview

N62-HYPERTROPHY-OF-BREAST

ICD-10-CM Code For Hypertrophy Of Breast: Group Overview

N63-UNSPECIFIED-LUMP-IN-BREAST

ICD-10-CM Code For Unspecified Lump In Breast: Group Overview

N65-DEFORMITY-AND-DISPROPORTION-RECONSTRUCTED-BREAST

ICD-10-CM Code For Deformity And Disproportion Of Reconstructed Breast: Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

ICD-10-CM Code For Other Disorders Of Breast: Group Overview

Sign up for ICD-10-CM Code For Other Disorders Of Breast: Group Overview policy alerts

ICD-10-CM N64: Other Disorders Of Breast Overview

ICD-10-CM Code For Other Disorders Of Breast: Group Overview

Sign up for ICD-10-CM Code For Other Disorders Of Breast: Group Overview policy alerts

ICD-10-CM N64: Other Disorders Of Breast Overview

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which conditions are included in the ICD-10-CM N64 group?

How should I document symptoms like breast pain or nipple discharge for coding?

What role does the N64 group play in reimbursement and claims adjudication?

Which `N64` codes capture structural breast abnormalities like ptosis or hypoplasia?

How are unspecified or other breast disorders coded within this group?

References

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which conditions are included in the ICD-10-CM N64 group?

How should I document symptoms like breast pain or nipple discharge for coding?

What role does the N64 group play in reimbursement and claims adjudication?

Which `N64` codes capture structural breast abnormalities like ptosis or hypoplasia?

How are unspecified or other breast disorders coded within this group?

References