ICD-10 Coding for Fibrocystic Changes(N60.19, N60.29)
Complete ICD-10-CM coding and documentation guide for Fibrocystic Changes. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Fibrocystic Changes
N60-N64Primary Range
Disorders of breast
This range includes codes for benign breast conditions, including fibrocystic changes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N60.19 | Diffuse cystic mastopathy of unspecified breast | Use when documenting diffuse fibrocystic changes without atypical hyperplasia. |
|
| N60.29 | Fibrocystic disease of breast with apocrine metaplasia | Use when apocrine metaplasia is documented. |
|
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 fibrocystic changes
Essential facts and insights about Fibrocystic Changes
Primary ICD-10-CM Codes for fibrocystic changes
Decision Criteria
clinical Criteria
- Presence of bilateral nodularity and absence of atypical hyperplasia
Applicable To
- Fibrocystic changes without atypia
Excludes
- Benign neoplasm of breast (D24.-)
Clinical Validation Requirements
- Bilateral nodularity
- Absence of epithelial proliferation
- Imaging confirmation
Code-Specific Risks
- Confusion with neoplastic conditions
Coding Notes
- Ensure documentation specifies absence of atypical hyperplasia.
N60.29 - Fibrocystic disease of breast with apocrine metaplasia
Use when apocrine metaplasia is documented.
Applicable To
- Apocrine metaplasia
Clinical Validation Requirements
- Cyst description with apocrine metaplasia
Coding Notes
Document apocrine metaplasia clearly.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Fibrocystic Changes to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N60.19.
Impact
Clinical: Inaccurate clinical records., Regulatory: Potential audit issues., Financial: Denied claims due to unspecified coding.
Mitigation Strategy
Always specify left, right, or bilateral., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with age-specific coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Use N64.89 for patients under 18 years.
Impact
Using unspecified codes when laterality is not documented.
Mitigation Strategy
Implement documentation templates that require laterality.
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 Fibrocystic Changes, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Fibrocystic Changes
Use these documentation templates to ensure complete and accurate documentation for Fibrocystic Changes. These templates include all required elements for proper coding and billing.
Routine Breast Exam
Specialty: RadiologyRequired Elements
- Patient history
- Physical exam findings
- Imaging results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Fibrocystic Changes? Ask your questions below.