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    v1.0.28
    OpenPayerBilling CodesComplications predominantly related to the puerperiumICD-10-CM o92-other-disorders-of-breast
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    ICD-10-CM Code For Other Disorders Of Breast And Disorders Of Lactation Associated With Pregnancy And The Puerperium: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group O92 includes disorders of the breast and disorders of lactation associated with pregnancy and the puerperium, such as engorgement, milk fistula, and other specified lactation problems. These ICD-10-CM diagnosis codes are used to document postpartum breast and lactation complications, capturing disease severity, laterality, and any associated clinical complexity relevant to breastfeeding and postpartum recovery. Accurate coding within the ICD-10-CM O92 group supports proper claim adjudication and complete clinical documentation and appropriate reimbursement.

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    ICD-10-CM O92: Other Disorders Of Breast And Disorders Of Lactation Associated With Pregnancy And The Puerperium Overview

    This code group represents noninfectious and lactation-related breast conditions that arise in the puerperium and during breastfeeding, targeting breast tissue and lactational function. Accurate coding ensures clinical records reflect the specific breast or lactation disorder and supports correct billing for postpartum care. Precise documentation of laterality, severity, and any complications is important for claim adjudication and continuity of care.

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    When to Use

    Use codes from this group when documenting breast or lactation complications that arise in the postpartum period or during breastfeeding and are directly related to pregnancy or the puerperium. Select the code that reflects the precise clinical finding, laterality, and any specified complication to ensure accurate recordkeeping and billing.

    ICD-10-CM Codes

    20 rows

    ICD-10-CM CodeDescription
    O92.011Retracted nipple associated with pregnancy, first trimester
    O92.012Retracted nipple associated with pregnancy, second trimester
    O92.013Retracted nipple associated with pregnancy, third trimester
    O92.019Retracted nipple associated with pregnancy, unspecified trimester
    O92.02Retracted nipple associated with the puerperium
    O92.03Retracted nipple associated with lactation
    O92.111Cracked nipple associated with pregnancy, first trimester
    O92.112Cracked nipple associated with pregnancy, second trimester
    O92.113Cracked nipple associated with pregnancy, third trimester
    O92.119Cracked nipple associated with pregnancy, unspecified trimester
    O92.12Cracked nipple associated with the puerperium
    O92.13Cracked nipple associated with lactation
    O92.20Unspecified disorder of breast associated with pregnancy and the puerperium
    O92.29Other disorders of breast associated with pregnancy and the puerperium
    O92.3Agalactia
    O92.4Hypogalactia
    O92.5Suppressed lactation
    O92.6Galactorrhea
    O92.70Unspecified disorders of lactation
    O92.79Other disorders of 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 breastfeeding mother presents to the emergency department with sudden onset of a painful, swollen, erythematous area on one breast accompanied by fever and purulent nipple discharge after delivery; ultrasound shows an abscess requiring incision and drainage and antibiotics, and a puerperal breast infection or abscess is documented, so a code for puerperal mastitis or breast abscess is assigned. Typical codes: O92.011, O92.012
    • A postpartum patient at a routine clinic follow-up reports persistent engorgement, cracked and bleeding nipples, and difficulty with milk expression several weeks after delivery despite lactation support; the clinician documents chronic lactation-related complications such as fissured nipple and ongoing milk stasis, leading to assignment of a code for nonacute disorders of lactation. Typical codes: O92.12, O92.13
    • A patient hospitalized for unrelated postpartum surgical care develops secondary cellulitis of the breast around a surgical drain site with localized inflammation but without abscess; this is documented as a puerperal breast infection complicating the postpartum course and is coded as an infectious or inflammatory complication of lactation/puerperium. Typical codes: O92.20, O92.29

    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

    O91-INFECTIONS-OF-BREAST-ASSOCIATED-WITH-PREGNANCY

    ICD-10-CM Code For Infections Of Breast Associated With Pregnancy The Puerperium And Lactation: 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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