The American College of Obstetricians and Gynecologists WOMEN’S HEALTH CARE PHYSICIANS Breastfeeding Coding for Obstetrician–Gynecologists 2016 The codes represented in this chart with an * require a 6th digit to specify trimester. The guidelines for 6th-digit requirements for this code set are as follows: 1 (first trimester), 2 (second trimester), 3 (third trimester), or 9 (unspecified trimester). The codes represented in this chart with an ^ require an additional digit as indicated with the dash (-). The guidelines for 7th-digit requirements for this code set are as follows: A (Initial Encounter), D (Subsequent Encounter), or S (Sequela). If a feeding problem exists that requires the physician to spend an additional amount of time addressing the problem, the following codes are appropriate. This would include the obstetrician–gynecologist or other health care provider taking the woman’s history, examining her breasts and nipples, observing a feeding, and making a diagnosis and treatment plan for the woman: 99201-99205 Office or other outpatient visit for the evaluation and management of a new patient 99212-99215 Office or other outpatient visit for the evaluation and management of an established patient ICD-10 Code Breastfeeding Condition O91.03 Infection of nipple associated with lactation O91.13 Abscess of breast associated with lactation O91.23 Nonpurulent mastitis associated with lactation O92.03 Retracted nipple associated with lactation O92.13 Cracked nipple associated with lactation O92.5 Suppressed lactation O92.70 Unspecified disorders of lactation O92.79 Other disorders of lactation *O91.01- Infection of nipple associated with pregnancy *O91.11- Abscess of breast associated with pregnancy *O91.21- Nonpurulent mastitis associated with pregnancy *O92.01- Retracted nipple associated with pregnancy *O92.11- Cracked nipple associated with pregnancy O92.20 Unspecified disorder of breast associated with pregnancy and the puerperium O92.29 Other disorders of breast associated with pregnancy and the puerperium O91.219 Nonpurulent mastitis associated with pregnancy, unspecified trimester O91.22 Nonpurulent mastitis associated with the puerperium ^S20.121- Blister (nonthermal) of breast, right breast ^S20.122- Blister (nonthermal) of breast, left breast B37.89 Candidiasis, breast or nipple L01.00 Impetigo, unspecified O91.02 Infection of nipple associated with the puerperium Q83.8 Other congenital malformations of breast (ectopic or axillary breast tissue) R20.3 Hyperesthesia (burning) O92.3 Agalactia O92.4 Hypogalactia O92.5 Suppressed lactation O92.6 Galactorrhea O92.70 Unspecified disorders of lactation O92.79 Galactocele (other disorders of lactation) Z39.1 Encounter for care and examination of lactating woman (excludes encounter for conditions related to O92.-) Commonly Used Codes for Breastfeeding Copyright 2016 The American College of Obstetricians and Gynecologists, 409 12th Street, SW, PO Box 96920, Washington, DC 20090-6920 AA612B

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