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N61.20 ICD-10-CM Code: Granulomatous mastitis, unspecified breast

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 600 — NON-MALIGNANT BREAST DISORDERS WITH CC/MCC (MDC 09)
  • MS-DRG 601 — NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC (MDC 09)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Official Registry Overview & Definition

Granulomatous mastitis, unspecified breast is a billable ICD-10-CM diagnosis code (N61.20).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for N61.20 in the official ICD-10-CM tabular list.

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).

Frequently Compared Codes

The official Excludes notes on N61.20 name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

  • FY2021 — 2020-10-01
    Added to the code set
    Granulomatous mastitis, unspecified breast
    FY2021 changes

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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

Contextual Map

Every relationship of N61.20 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.

Hierarchy

  • N00-N99 — Chapter 14: Diseases of the Genitourinary System (N00-N99) (N00-N99) [Hierarchy]
  • N60-N65 — Disorders of breast [Hierarchy]

Clinical classification (CCSR)

  • GEN017 — Nonmalignant breast conditions [CCSR]

Potential MS-DRG

  • DRG 600 — NON-MALIGNANT BREAST DISORDERS WITH CC/MCC [MS-DRG]: “NON-MALIGNANT BREAST DISORDERS WITH CC/MCC (MDC 09)”
  • DRG 601 — NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC [MS-DRG]: “NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC (MDC 09)”

MDC crossing · procedures (7376)

  • MDC 09 — Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast [MDC crossing]: “Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 0315090 — Bypass Right Axillary Artery to Right Upper Arm Artery with Autologous Venous Tissue, Open Approach [Same-MDC procedure]: “Bypass Right Axillary Artery to Right Upper Arm Artery with Autologous Venous Tissue, Open Approach — grouped in MDC 09, the procedure side of this code's crossing.” · check together
  • 031509W — Bypass Right Axillary Artery to Lower Extremity Vein with Autologous Venous Tissue, Open Approach [Same-MDC procedure]: “Bypass Right Axillary Artery to Lower Extremity Vein with Autologous Venous Tissue, Open Approach — grouped in MDC 09, the procedure side of this code's crossing.” · check together
  • 03150A0 — Bypass Right Axillary Artery to Right Upper Arm Artery with Autologous Arterial Tissue, Open Approach [Same-MDC procedure]: “Bypass Right Axillary Artery to Right Upper Arm Artery with Autologous Arterial Tissue, Open Approach — grouped in MDC 09, the procedure side of this code's crossing.” · check together
  • 03150AW — Bypass Right Axillary Artery to Lower Extremity Vein with Autologous Arterial Tissue, Open Approach [Same-MDC procedure]: “Bypass Right Axillary Artery to Lower Extremity Vein with Autologous Arterial Tissue, Open Approach — grouped in MDC 09, the procedure side of this code's crossing.” · check together
  • 03150J0 — Bypass Right Axillary Artery to Right Upper Arm Artery with Synthetic Substitute, Open Approach [Same-MDC procedure]: “Bypass Right Axillary Artery to Right Upper Arm Artery with Synthetic Substitute, Open Approach — grouped in MDC 09, the procedure side of this code's crossing.” · check together
  • and 7371 more

Nearest codes

  • N61 — Inflammatory disorders of breast [Sibling]
  • N61.0 — Mastitis without abscess [Sibling]
  • N61.1 — Abscess of the breast and nipple [Sibling]
  • N61.2 — Granulomatous mastitis [Sibling]
  • N61.21 — Granulomatous mastitis, right breast [Sibling]
  • N61.22 — Granulomatous mastitis, left breast [Sibling]
  • N61.23 — Granulomatous mastitis, bilateral breast [Sibling]

Change history

  • FY2021 — Added to the code set [Change history]

Relationships & Classification

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.

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 2 MS-DRGs: DRG 600 (MDC 09), DRG 601 (MDC 09).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to N61.20 in its code family, with their registry titles.

  • N61 — Inflammatory disorders of breast
  • N61.0 — Mastitis without abscess
  • N61.1 — Abscess of the breast and nipple
  • N61.2 — Granulomatous mastitis
  • N61.21 — Granulomatous mastitis, right breast
  • N61.22 — Granulomatous mastitis, left breast
  • N61.23 — Granulomatous mastitis, bilateral breast

View all codes in the N61 family