{"code":"O91.11","type":"code","title":"Abscess of breast associated with pregnancy","codeAlso":[],"includes":[],"modern_v":"official26","codeFirst":[],"excludes1":[],"excludes2":["mental and behavioral disorders associated with the puerperium (F53.-)","obstetrical tetanus (A34)","puerperal osteomalacia (M83.0)"],"isBillable":false,"fyEffectivity":{"fy2026":true,"fy2027":true,"billableFy2026":false,"billableFy2027":false},"sibling_codes":["O91.111","O91.112","O91.113","O91.119"],"inclusionTerms":["Gestational mammary abscess","Gestational purulent mastitis","Gestational subareolar abscess"],"sibling_titles":{"code":"O91.119","title":"Abscess of breast associated with pregnancy, unspecified trimester","isBillable":true},"useAdditionalCode":["code to identify infection"],"clinicalDefinition":"Abscess of breast associated with pregnancy is a non-billable ICD-10-CM category code (O91.11). A more specific billable subcode must be selected for claims submission. Inclusion terms: Gestational mammary abscess; Gestational purulent mastitis; Gestational subareolar abscess. Excludes2 (not included here): mental and behavioral disorders associated with the puerperium (F53.-); obstetrical tetanus (A34); puerperal osteomalacia (M83.0). Use additional code: code to identify infection.","officialDefinition":"Abscess of breast associated with pregnancy is a non-billable ICD-10-CM category code (O91.11). A more specific billable subcode must be selected for claims submission. Inclusion terms: Gestational mammary abscess; Gestational purulent mastitis; Gestational subareolar abscess. Excludes2 (not included here): mental and behavioral disorders associated with the puerperium (F53.-); obstetrical tetanus (A34); puerperal osteomalacia (M83.0). Use additional code: code to identify infection.","seventhCharacterInstructions":[],"workflowProtocols":[],"guidelines":{"whenToUse":[],"whenNotToUse":[],"commonBillingMistakes":[],"codeComparisons":[],"documentationChecklist":[]},"domainLandscape":{"summary":"Primary diagnostic domain and clinical landscape evaluation.","keyCategories":[],"diagnosticContinuum":"Progression continuum from acute presentation to resolution."},"children":[],"hierarchy":[],"relatedCodes":[],"relevantCPTCodes":[],"documentationTips":[],"caseStudies":[],"description":"","overview":"","noteProvenance":{"mental and behavioral disorders associated with the puerperium (F53.-)":"O91","obstetrical tetanus (A34)":"O91","puerperal osteomalacia (M83.0)":"O91","code to identify infection":"O91"},"hcc":{"mapped":false,"model":"CMS-HCC V28","paymentYear":"2026","categories":[],"otherModels":[]}}