ICD-10 Coding for Bilateral Breast Cysts(N60.11, N60.12)
Complete ICD-10-CM coding and documentation guide for Bilateral Breast Cysts. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Bilateral Breast Cysts
N60.0-N60.9Primary Range
Benign mammary dysplasias
This range includes codes for various types of benign breast conditions, including cysts.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N60.11 | Diffuse cystic mastopathy, right breast | Use when diffuse cystic changes are confirmed in the right breast. |
|
| N60.12 | Diffuse cystic mastopathy, left breast | Use when diffuse cystic changes are confirmed in the left breast. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for bilateral breast cysts
Essential facts and insights about Bilateral Breast Cysts
Primary ICD-10-CM Codes for bilateral breast cysts
Decision Criteria
clinical Criteria
- Presence of multiple cysts in the right breast confirmed by imaging
Applicable To
- Diffuse cystic changes in the right breast
Excludes
- Malignant neoplasm of breast (C50.-)
Clinical Validation Requirements
- Ultrasound confirmation of cysts in the right breast
- Documentation of cyst size and location
Code-Specific Risks
- Risk of using unspecified codes if laterality is not documented
Coding Notes
- Ensure laterality is documented to avoid unspecified codes.
N60.12 - Diffuse cystic mastopathy, left breast
Use when diffuse cystic changes are confirmed in the left breast.
Applicable To
- Diffuse cystic changes in the left breast
Excludes
- Malignant neoplasm of breast (C50.-)
Clinical Validation Requirements
- Ultrasound confirmation of cysts in the left breast
- Documentation of cyst size and location
Coding Notes
Ensure laterality is documented to avoid unspecified codes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for screening mammogram for malignant neoplasm of breast
Z12.31Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Bilateral Breast Cysts to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N60.11.
Impact
Clinical: May lead to inappropriate follow-up recommendations., Regulatory: Non-compliance with reporting standards., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Ensure BI-RADS category is included in all imaging reports., Use standardized templates for documentation.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Always specify laterality using N60.11 for right and N60.12 for left breast.
Impact
Using unspecified codes when laterality is documented.
Mitigation Strategy
Always document laterality and use specific codes.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Bilateral Breast Cysts, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Bilateral Breast Cysts
Use these documentation templates to ensure complete and accurate documentation for Bilateral Breast Cysts. These templates include all required elements for proper coding and billing.
Bilateral Breast Cysts Detected on Mammogram
Specialty: RadiologyRequired Elements
- Laterality
- Cyst size and location
- BI-RADS category
- Comparison with previous imaging
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Bilateral Breast Cysts? Ask your questions below.