ICD-10 Coding for Breast Fibrosis(N60.3, N60.31, N60.32)
Complete ICD-10-CM coding and documentation guide for Breast Fibrosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Breast Fibrosis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N60.3 | Fibrosclerosis of breast | Use when fibrosclerosis is confirmed by biopsy or imaging. |
|
| N60.31 | Fibrosclerosis of right breast | Use when fibrosclerosis is confirmed in the right breast. |
|
| N60.32 | Fibrosclerosis of left breast | Use when fibrosclerosis is confirmed in the left breast. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for breast fibrosis
Essential facts and insights about Breast Fibrosis
Primary ICD-10-CM Codes for breast fibrosis
Decision Criteria
clinical Criteria
- Biopsy confirms fibrosclerosis
coding Criteria
- Exclude neoplasm codes unless confirmed
Applicable To
- Cystic mastopathy with epithelial proliferation
Excludes
- Benign neoplasm of breast (D24)
Clinical Validation Requirements
- Histologic confirmation of fibrosclerosis
- Imaging findings such as architectural distortion
Code-Specific Risks
- Misclassification with benign neoplasm codes
Coding Notes
- Ensure histological confirmation before using N60.3.
N60.31 - Fibrosclerosis of right breast
Use when fibrosclerosis is confirmed in the right breast.
Clinical Validation Requirements
- Biopsy confirmation specific to right breast
Coding Notes
Specify laterality for accurate coding.
N60.32 - Fibrosclerosis of left breast
Use when fibrosclerosis is confirmed in the left breast.
Clinical Validation Requirements
- Biopsy confirmation specific to left breast
Coding Notes
Specify laterality for accurate coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other specified disorders of breast
N64.89Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Breast Fibrosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N60.3.
Impact
Clinical: Ambiguity in treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always document the affected breast side.
Impact
Reimbursement: Incorrect reimbursement due to misclassification., Compliance: Non-compliance with coding guidelines., Data Quality: Poor data quality affecting clinical records.
Mitigation Strategy
Ensure fibrosclerosis is not coded as a neoplasm.
Impact
Lack of biopsy confirmation can lead to audit issues.
Mitigation Strategy
Ensure all cases of fibrosclerosis have biopsy documentation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Breast Fibrosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Breast Fibrosis
Use these documentation templates to ensure complete and accurate documentation for Breast Fibrosis. These templates include all required elements for proper coding and billing.
Biopsy-confirmed fibrosclerosis
Specialty: RadiologyRequired Elements
- Biopsy results
- Imaging findings
- Laterality
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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