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    v1.0.28
    OpenPayerBilling CodesComplications predominantly related to the puerperiumICD-10-CM o91-infections-of-breast-associated-with-pregnancy
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    ICD-10-CM Code For Infections Of Breast Associated With Pregnancy The Puerperium And Lactation: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group O91 includes infections of the breast related to pregnancy, the puerperium and lactation, such as lactational mastitis and breast abscesses occurring in the peripartum period. These ICD-10-CM diagnosis codes are used to document maternal breast infections that may affect breastfeeding, involve abscess formation, or require surgical or medical intervention, capturing disease severity and anatomic involvement. Accurate coding within the ICD-10-CM O91 group supports proper claim adjudication and complete clinical documentation for appropriate reimbursement.

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    ICD-10-CM O91: Infections Of Breast Associated With Pregnancy, The Puerperium And Lactation Overview

    This group represents infections of the breast that occur in association with pregnancy, the postpartum period, and lactation, including mastitis and related abscesses. These conditions affect the breast and associated mammary structures and can impact maternal health and the ability to breastfeed. Accurate coding is important for complete clinical documentation and for appropriate reimbursement and claim processing.

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    When to Use

    Use a code from this group when a documented breast infection is clinically associated with pregnancy, the puerperium, or lactation, including instances of mastitis or abscess in a breastfeeding mother. Select the most specific code that reflects the diagnosis, laterality if specified, and any documented complications such as abscess formation.

    ICD-10-CM Codes

    18 rows

    ICD-10-CM CodeDescription
    O91.011Infection of nipple associated with pregnancy, first trimester
    O91.012Infection of nipple associated with pregnancy, second trimester
    O91.013Infection of nipple associated with pregnancy, third trimester
    O91.019Infection of nipple associated with pregnancy, unspecified trimester
    O91.02Infection of nipple associated with the puerperium
    O91.03Infection of nipple associated with lactation
    O91.111Abscess of breast associated with pregnancy, first trimester
    O91.112Abscess of breast associated with pregnancy, second trimester
    O91.113Abscess of breast associated with pregnancy, third trimester
    O91.119Abscess of breast associated with pregnancy, unspecified trimester
    O91.12Abscess of breast associated with the puerperium
    O91.13Abscess of breast associated with lactation
    O91.211Nonpurulent mastitis associated with pregnancy, first trimester
    O91.212Nonpurulent mastitis associated with pregnancy, second trimester
    O91.213Nonpurulent mastitis associated with pregnancy, third trimester
    O91.219Nonpurulent mastitis associated with pregnancy, unspecified trimester
    O91.22Nonpurulent mastitis associated with the puerperium
    O91.23Nonpurulent mastitis associated with lactation

    DRG Codes

    8 rows

    DRG CodeDescription
    769Postpartum and Post Abortion Diagnoses with O.R. Procedures
    776Postpartum and Post Abortion Diagnoses without O.R. Procedures
    817Other Antepartum Diagnoses with O.R. Procedures with MCC
    818Other Antepartum Diagnoses with O.R. Procedures with CC
    819Other Antepartum Diagnoses with O.R. Procedures without CC/MCC
    831Other Antepartum Diagnoses without O.R. Procedures with MCC
    832Other Antepartum Diagnoses without O.R. Procedures with CC
    833Other Antepartum Diagnoses without O.R. Procedures without CC/MCC

    Typical Clinical Scenarios

    • A postpartum patient 5 days after vaginal delivery presents with fever, unilateral breast erythema, warmth, and a tender, fluctuant mass at the nipple suggestive of a breast abscess complicating lactation. She reports difficulty breastfeeding from the affected side and purulent nipple discharge on expression; physical exam and ultrasound confirm an intramammary fluid collection. A code indicating an acute lactational breast abscess is assigned. Typical codes: O91.011, O91.012
    • A breastfeeding mother several weeks postpartum has progressive bilateral nipple and areolar pain with cracked nipples, low-grade systemic symptoms, and chronic mastitis related to ongoing nipple trauma and milk stasis. She has repeated clinic visits for management of persistent nonpurulent inflammatory changes without abscess formation, representing a subacute or chronic lactational infection requiring continued evaluation and care. Typical codes: O91.111, O91.112, O91.119
    • A recently delivered patient in the immediate puerperium develops severe systemic signs (high fever, tachycardia) with one-sided breast cellulitis and a small area of purulent drainage after attempted needle aspiration for a blocked duct; the infection is complicated by sepsis risk and need for inpatient IV antibiotics. A code reflecting an infected breast with purulent drainage in the puerperium is assigned to capture the complication and guide inpatient management. Typical codes: O91.213, O91.219

    Related Codes

    O85-PUERPERAL-SEPSIS

    ICD-10-CM Code For Puerperal Sepsis: Group Overview

    O86-OTHER-PUERPERAL-INFECTIONS

    ICD-10-CM Code For Other Puerperal Infections: Group Overview

    O87-VENOUS-COMPLICATIONS-AND-HEMORRHOIDS

    ICD-10-CM Code For Venous Complications And Hemorrhoids In The Puerperium: Group Overview

    O88-OBSTETRIC-EMBOLISM

    ICD-10-CM Code For Obstetric Embolism: Group Overview

    O89-COMPLICATIONS-OF-ANESTHESIA-DURING-THE-PUERPERIUM

    ICD-10-CM Code For Complications Of Anesthesia During The Puerperium: Group Overview

    O90-COMPLICATIONS-OF-THE-PUERPERIUM

    ICD-10-CM Code For Complications Of The Puerperium, Not Elsewhere Classified: Group Overview

    O92-OTHER-DISORDERS-OF-BREAST

    ICD-10-CM Code For Other Disorders Of Breast And Disorders Of Lactation Associated With Pregnancy And The Puerperium: Group Overview

    Frequently Asked Questions

    References

    1. 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. 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. 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.
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