ICD-10-CM/PCS MS-DRG v37.1 R1 Definitions Manual
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ICD-10-CM/PCS MS-DRG v37.1 R1 Definitions Manual |
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| MDC 09 Diseases & Disorders of the Skin, Subcutaneous Tissue & Breast |
| Breast Disorders |
| Malignancy | MCC | CC | CC or MCC | DRG |
|---|---|---|---|---|
| Yes | Yes | n/a | n/a | 597 |
| Yes | No | Yes | n/a | 598 |
| Yes | No | No | n/a | 599 |
| No | Yes | 600 | ||
| No | No | 601 |
DRG 597 MALIGNANT BREAST DISORDERS WITH MCC
DRG 598 MALIGNANT BREAST DISORDERS WITH CC
DRG 599 MALIGNANT BREAST DISORDERS WITHOUT CC/MCC
DRG 600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC
DRG 601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC
MALIGNANT BREAST DISORDERS
PRINCIPAL DIAGNOSIS
| C50011 | Malignant neoplasm of nipple and areola, right female breast |
| C50012 | Malignant neoplasm of nipple and areola, left female breast |
| C50019 | Malignant neoplasm of nipple and areola, unspecified female breast |
| C50021 | Malignant neoplasm of nipple and areola, right male breast |
| C50022 | Malignant neoplasm of nipple and areola, left male breast |
| C50029 | Malignant neoplasm of nipple and areola, unspecified male breast |
| C50111 | Malignant neoplasm of central portion of right female breast |
| C50112 | Malignant neoplasm of central portion of left female breast |
| C50119 | Malignant neoplasm of central portion of unspecified female breast |
| C50121 | Malignant neoplasm of central portion of right male breast |
| C50122 | Malignant neoplasm of central portion of left male breast |
| C50129 | Malignant neoplasm of central portion of unspecified male breast |
| C50211 | Malignant neoplasm of upper-inner quadrant of right female breast |
| C50212 | Malignant neoplasm of upper-inner quadrant of left female breast |
| C50219 | Malignant neoplasm of upper-inner quadrant of unspecified female breast |
| C50221 | Malignant neoplasm of upper-inner quadrant of right male breast |
| C50222 | Malignant neoplasm of upper-inner quadrant of left male breast |
| C50229 | Malignant neoplasm of upper-inner quadrant of unspecified male breast |
| C50311 | Malignant neoplasm of lower-inner quadrant of right female breast |
| C50312 | Malignant neoplasm of lower-inner quadrant of left female breast |
| C50319 | Malignant neoplasm of lower-inner quadrant of unspecified female breast |
| C50321 | Malignant neoplasm of lower-inner quadrant of right male breast |
| C50322 | Malignant neoplasm of lower-inner quadrant of left male breast |
| C50329 | Malignant neoplasm of lower-inner quadrant of unspecified male breast |
| C50411 | Malignant neoplasm of upper-outer quadrant of right female breast |
| C50412 | Malignant neoplasm of upper-outer quadrant of left female breast |
| C50419 | Malignant neoplasm of upper-outer quadrant of unspecified female breast |
| C50421 | Malignant neoplasm of upper-outer quadrant of right male breast |
| C50422 | Malignant neoplasm of upper-outer quadrant of left male breast |
| C50429 | Malignant neoplasm of upper-outer quadrant of unspecified male breast |
| C50511 | Malignant neoplasm of lower-outer quadrant of right female breast |
| C50512 | Malignant neoplasm of lower-outer quadrant of left female breast |
| C50519 | Malignant neoplasm of lower-outer quadrant of unspecified female breast |
| C50521 | Malignant neoplasm of lower-outer quadrant of right male breast |
| C50522 | Malignant neoplasm of lower-outer quadrant of left male breast |
| C50529 | Malignant neoplasm of lower-outer quadrant of unspecified male breast |
| C50611 | Malignant neoplasm of axillary tail of right female breast |
| C50612 | Malignant neoplasm of axillary tail of left female breast |
| C50619 | Malignant neoplasm of axillary tail of unspecified female breast |
| C50621 | Malignant neoplasm of axillary tail of right male breast |
| C50622 | Malignant neoplasm of axillary tail of left male breast |
| C50629 | Malignant neoplasm of axillary tail of unspecified male breast |
| C50811 | Malignant neoplasm of overlapping sites of right female breast |
| C50812 | Malignant neoplasm of overlapping sites of left female breast |
| C50819 | Malignant neoplasm of overlapping sites of unspecified female breast |
| C50821 | Malignant neoplasm of overlapping sites of right male breast |
| C50822 | Malignant neoplasm of overlapping sites of left male breast |
| C50829 | Malignant neoplasm of overlapping sites of unspecified male breast |
| C50911 | Malignant neoplasm of unspecified site of right female breast |
| C50912 | Malignant neoplasm of unspecified site of left female breast |
| C50919 | Malignant neoplasm of unspecified site of unspecified female breast |
| C50921 | Malignant neoplasm of unspecified site of right male breast |
| C50922 | Malignant neoplasm of unspecified site of left male breast |
| C50929 | Malignant neoplasm of unspecified site of unspecified male breast |
| C792 | Secondary malignant neoplasm of skin |
| C7981 | Secondary malignant neoplasm of breast |
| D0500 | Lobular carcinoma in situ of unspecified breast |
| D0501 | Lobular carcinoma in situ of right breast |
| D0502 | Lobular carcinoma in situ of left breast |
| D0510 | Intraductal carcinoma in situ of unspecified breast |
| D0511 | Intraductal carcinoma in situ of right breast |
| D0512 | Intraductal carcinoma in situ of left breast |
| D0580 | Other specified type of carcinoma in situ of unspecified breast |
| D0581 | Other specified type of carcinoma in situ of right breast |
| D0582 | Other specified type of carcinoma in situ of left breast |
| D0590 | Unspecified type of carcinoma in situ of unspecified breast |
| D0591 | Unspecified type of carcinoma in situ of right breast |
| D0592 | Unspecified type of carcinoma in situ of left breast |
| D4860 | Neoplasm of uncertain behavior of unspecified breast |
| D4861 | Neoplasm of uncertain behavior of right breast |
| D4862 | Neoplasm of uncertain behavior of left breast |
NON-MALIGNANT BREAST DISORDERS
PRINCIPAL DIAGNOSIS
| D493 | Neoplasm of unspecified behavior of breast |
| I972 | Postmastectomy lymphedema syndrome |
| N6001 | Solitary cyst of right breast |
| N6002 | Solitary cyst of left breast |
| N6009 | Solitary cyst of unspecified breast |
| N6011 | Diffuse cystic mastopathy of right breast |
| N6012 | Diffuse cystic mastopathy of left breast |
| N6019 | Diffuse cystic mastopathy of unspecified breast |
| N6021 | Fibroadenosis of right breast |
| N6022 | Fibroadenosis of left breast |
| N6029 | Fibroadenosis of unspecified breast |
| N6031 | Fibrosclerosis of right breast |
| N6032 | Fibrosclerosis of left breast |
| N6039 | Fibrosclerosis of unspecified breast |
| N6041 | Mammary duct ectasia of right breast |
| N6042 | Mammary duct ectasia of left breast |
| N6049 | Mammary duct ectasia of unspecified breast |
| N6081 | Other benign mammary dysplasias of right breast |
| N6082 | Other benign mammary dysplasias of left breast |
| N6089 | Other benign mammary dysplasias of unspecified breast |
| N6091 | Unspecified benign mammary dysplasia of right breast |
| N6092 | Unspecified benign mammary dysplasia of left breast |
| N6099 | Unspecified benign mammary dysplasia of unspecified breast |
| N610 | Mastitis without abscess |
| N611 | Abscess of the breast and nipple |
| N62 | Hypertrophy of breast |
| N630 | Unspecified lump in unspecified breast |
| N6310 | Unspecified lump in the right breast, unspecified quadrant |
| N6311 | Unspecified lump in the right breast, upper outer quadrant |
| N6312 | Unspecified lump in the right breast, upper inner quadrant |
| N6313 | Unspecified lump in the right breast, lower outer quadrant |
| N6314 | Unspecified lump in the right breast, lower inner quadrant |
| N6315 | Unspecified lump in the right breast, overlapping quadrants |
| N6320 | Unspecified lump in the left breast, unspecified quadrant |
| N6321 | Unspecified lump in the left breast, upper outer quadrant |
| N6322 | Unspecified lump in the left breast, upper inner quadrant |
| N6323 | Unspecified lump in the left breast, lower outer quadrant |
| N6324 | Unspecified lump in the left breast, lower inner quadrant |
| N6325 | Unspecified lump in the left breast, overlapping quadrants |
| N6331 | Unspecified lump in axillary tail of the right breast |
| N6332 | Unspecified lump in axillary tail of the left breast |
| N6341 | Unspecified lump in right breast, subareolar |
| N6342 | Unspecified lump in left breast, subareolar |
| N640 | Fissure and fistula of nipple |
| N641 | Fat necrosis of breast |
| N642 | Atrophy of breast |
| N643 | Galactorrhea not associated with childbirth |
| N644 | Mastodynia |
| N6451 | Induration of breast |
| N6452 | Nipple discharge |
| N6453 | Retraction of nipple |
| N6459 | Other signs and symptoms in breast |
| N6481 | Ptosis of breast |
| N6482 | Hypoplasia of breast |
| N6489 | Other specified disorders of breast |
| N649 | Disorder of breast, unspecified |
| N650 | Deformity of reconstructed breast |
| N651 | Disproportion of reconstructed breast |
| Q830 | Congenital absence of breast with absent nipple |
| Q831 | Accessory breast |
| Q832 | Absent nipple |
| Q833 | Accessory nipple |
| Q838 | Other congenital malformations of breast |
| Q839 | Congenital malformation of breast, unspecified |
| R920 | Mammographic microcalcification found on diagnostic imaging of breast |
| R921 | Mammographic calcification found on diagnostic imaging of breast |
| R922 | Inconclusive mammogram |
| R928 | Other abnormal and inconclusive findings on diagnostic imaging of breast |
| T8541XA | Breakdown (mechanical) of breast prosthesis and implant, initial encounter |
| T8542XA | Displacement of breast prosthesis and implant, initial encounter |
| T8543XA | Leakage of breast prosthesis and implant, initial encounter |
| T8544XA | Capsular contracture of breast implant, initial encounter |
| T8549XA | Other mechanical complication of breast prosthesis and implant, initial encounter |
| Z4001 | Encounter for prophylactic removal of breast |
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Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244 23 Mar 2020 12:40:01 CMS, code-revision=249, description-revision=1272 |