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O92.5 ICD-10-CM Code: Suppressed lactation

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

Coding at a Glance

Tabular directives
3 inclusion terms · 1 Excludes1 · 3 Excludes2

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

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

  • MS-DRG 769 — POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES (MDC 14)
  • MS-DRG 776 — POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES (MDC 14)

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.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for O92.5 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 O92.5 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Elective agalactia
  • Secondary agalactia
  • Therapeutic agalactia

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).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from O85-O92

Coder workflow for O92.5

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

Before you code O92.5

  1. Confirm the condition is documented as complicating the pregnancy, childbirth, or the puerperium, and check the trimester where the code carries one and the fetus character where the category requires it. Chapter 15 codes belong on the maternal record only and take sequencing priority over codes from other chapters. It is the provider’s responsibility to state that a condition is not affecting the pregnancy; the trimester is assigned from the documentation (Guidelines I.C.15.a, I.C.15.a.1, I.C.15.a.3).

    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 O92.5. 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 a condition named in O92.5’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.

    ReviewO92.3

Consider O92.5. 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).
Trimester
Assigned from the documented trimester at the encounter, or the trimester in which the condition developed for inpatient stays (Guidelines I.C.15.a.3).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).

Official instructions as workflow

  • Excludes1 — check before selecting O92.5(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with O92.5: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareO92.3

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

  • Excludes2 — not part of O92.5(3 notes)

    Coding workflow: The conditions named in this note are not included in O92.5. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareF53, A34, M83.0

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

Coding decision scenarios

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

Documentation: Both the condition O92.5 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).

ReviewO92.3

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

Suppressed lactation is a billable ICD-10-CM diagnosis code (O92.5).

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

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Verify Before Coding

  • Age-restricted: the Medicare Code Editor lists this as a maternity (age 9-64) diagnosis; other ages are presumed incorrect.

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

Other codes that name O92.5 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 9 Excludes1 notes across 3 chapters: N60 — Benign mammary dysplasia (via O92.-), N60-N65 — Disorders of breast (N60-N65) (via O92.-), N61 — Inflammatory disorders of breast (via O92.-), N62 — Hypertrophy of breast (via O92.-), N63 — Unspecified lump in breast (via O92.-), N64 — Other disorders of breast (via O92.-), N65 — Deformity and disproportion of reconstructed breast (via O92.-), O92.3 — Agalactia, Z39.1 — Encounter for care and examination of lactating mother (via O92.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 2 MS-DRGs: DRG 769 (MDC 14), DRG 776 (MDC 14).

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

Clinical classification (AHRQ CCSR):PRG027 — Complications specified during the puerperium (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 (Complications specified during the puerperium).

O91.22 — Nonpurulent mastitis associated with the puerperium, O91.23 — Nonpurulent mastitis associated with lactation, O92.02 — Retracted nipple associated with the puerperium, O92.03 — Retracted nipple associated with lactation, O92.12 — Cracked nipple associated with the puerperium, O92.13 — Cracked nipple associated with lactation, O92.20 — Unspecified disorder of breast associated with pregnancy and the puerperium, O92.29 — Other disorders of breast associated with pregnancy and the puerperium, O92.3 — Agalactia, O92.4 — Hypogalactia, O92.6 — Galactorrhea, O92.70 — Unspecified disorders of lactation, O92.79 — Other disorders of lactation, O98.03 — Tuberculosis complicating the puerperium, O98.13 — Syphilis complicating the puerperium, O98.23 — Gonorrhea complicating the puerperium, O98.33 — Other infections with a predominantly sexual mode of transmission complicating the puerperium, O98.43 — Viral hepatitis complicating the puerperium, O98.53 — Other viral diseases complicating the puerperium, O98.63 — Protozoal diseases complicating the puerperium, +113 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Suppression”; these codes share that main term but sit in a different category of the Tabular List.

E28.39 — Other primary ovarian failure (ovarian secretion), H53.34 — Suppression of binocular vision (binocular vision), N28.9 — Disorder of kidney and ureter, unspecified (renal), N94.89 — Other specified conditions associated with female genital organs and menstrual cycle (menstruation), R34 — Anuria and oliguria (urine, urinary secretion)

Contextual Map

Every relationship of O92.5 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 O92.5 with these 8 related codes in Claim Check

Hierarchy

Excludes1

  • O92.3 — Agalactia[Excludes1]: “primary agalactia (O92.3)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes1 notes (9)

  • N60 — Benign mammary dysplasia[Excludes1](via O92.-): “disorders of breast associated with childbirth (O91-O92)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • N60-N65 — Disorders of breast (N60-N65)[Excludes1](via O92.-): “disorders of breast associated with childbirth (O91-O92)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • N61 — Inflammatory disorders of breast[Excludes1](via O92.-): “disorders of breast associated with childbirth (O91-O92)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • N62 — Hypertrophy of breast[Excludes1](via O92.-): “disorders of breast associated with childbirth (O91-O92)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • N63 — Unspecified lump in breast[Excludes1](via O92.-): “disorders of breast associated with childbirth (O91-O92)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • N64 — Other disorders of breast[Excludes1](via O92.-): “disorders of breast associated with childbirth (O91-O92)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • N65 — Deformity and disproportion of reconstructed breast[Excludes1](via O92.-): “disorders of breast associated with childbirth (O91-O92)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • O92.3 — Agalactia[Excludes1]: “Elective agalactia (O92.5)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • and 1 more

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 14 — Pregnancy, Childbirth and the Puerperium[MDC crossing]: “Pregnancy, Childbirth and the Puerperium — 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. 94 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Agalactia (primary), elective, secondary or therapeutic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Suppression, lactation[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (26)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

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
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 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. "O92.5 — Suppressed lactation." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/o92.5-suppressed-lactation

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Suppressed lactation

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to O92.5 in its code family, with their registry titles.

View all codes in the O92 family