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N61 ICD-10-CM Code: Inflammatory disorders of breast

Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.

Coding at a Glance

Tabular directives
5 Excludes1

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for N61 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on N61 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Coder workflow for N61

MedCoder structured workflow — derived from this code’s own official record

Before you code N61

  1. N61 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewN61.0, N61.1, N61.2

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with N61. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support one of the more specific codes beneath N61?
    Yes → Select that code and continue the checks below on its own page.
    No → N61 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewN61.0, N61.1, N61.2

  2. Does the documentation support a condition named in N61’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewC50.A, O91, P39.0

Consider N61. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Official instructions as workflow

  • Excludes1 — check before selecting N61(5 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with N61: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareC50.A, O91, P39.0

    See the official tabular notes · Guidelines I.A.12.a

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition N61 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewC50.A, O91, P39.0

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Inflammatory disorders of breast is a non-billable ICD-10-CM category code (N61). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Clinical classification (AHRQ CCSR):GEN017 — Nonmalignant breast conditions (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Nonmalignant breast conditions).

N60.39 — Fibrosclerosis of unspecified breast, N60.41 — Mammary duct ectasia of right breast, N60.42 — Mammary duct ectasia of left breast, N60.49 — Mammary duct ectasia of unspecified breast, N60.81 — Other benign mammary dysplasias of right breast, N60.82 — Other benign mammary dysplasias of left breast, N60.89 — Other benign mammary dysplasias of unspecified breast, N60.91 — Unspecified benign mammary dysplasia of right breast, N60.92 — Unspecified benign mammary dysplasia of left breast, N60.99 — Unspecified benign mammary dysplasia of unspecified breast, N61.0 — Mastitis without abscess, N61.1 — Abscess of the breast and nipple, N61.20 — Granulomatous mastitis, unspecified breast, N61.21 — Granulomatous mastitis, right breast, N61.22 — Granulomatous mastitis, left breast, N61.23 — Granulomatous mastitis, bilateral breast, N62 — Hypertrophy of breast, N63 — Unspecified lump in breast, N63.0 — Unspecified lump in unspecified breast, N63.10 — Unspecified lump in the right breast, unspecified quadrant, +65 more

Contextual Map

Every relationship of N61 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run N61 with these 5 related codes in Claim Check

Hierarchy

Excludes1

Clinical classification (CCSR)

Nearest codes

Change history (2)

Common coding questions

Can N61 be billed directly?

No. N61 (Inflammatory disorders of breast) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "N61 — Inflammatory disorders of breast." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/n61-inflammatory-disorders-of-breast

Change history

  • FY2017 — October 1, 2016
    Became a non-billable header
    FY2017 changes
  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Inflammatory disorders of breast

Nearest Codes in This Family

Official ICD-10-CM classifications closest to N61 in its code family, with their registry titles.