ICD-10 Coding for Breast Hypertrophy(N62)
Complete ICD-10-CM coding and documentation guide for Breast Hypertrophy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Breast Hypertrophy
N60-N64Primary Range
Disorders of breast
This range includes conditions related to breast tissue disorders, with N62 specifically addressing hypertrophy.
Key Information: ICD-10 code for breast hypertrophy
Essential facts and insights about Breast Hypertrophy
Primary ICD-10-CM Code for breast hypertrophy
Decision Criteria
clinical Criteria
- Symptoms persist despite 6 weeks of conservative measures.
documentation Criteria
- Include photographic evidence and physical findings.
Applicable To
- Macromastia
- Breast enlargement
Clinical Validation Requirements
- Documentation of symptoms such as chronic pain, intertrigo, or back pain
- Physical findings like shoulder grooving or kyphosis
- Photographic evidence
Code-Specific Risks
- Using N62 without supporting symptom codes
- Misapplying codes for gynecomastia in females
Coding Notes
- Ensure documentation supports the linkage between symptoms and breast hypertrophy.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Disproportion of reconstructed breast
N65.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Breast Hypertrophy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N62.
Impact
Clinical: Inadequate justification for treatment, Regulatory: Non-compliance with payer requirements, Financial: Potential claim denials
Mitigation Strategy
Always specify symptom duration and treatment history., Use templates to ensure completeness.
Impact
Reimbursement: Claims may be denied due to lack of medical necessity., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of patient condition.
Mitigation Strategy
Always pair N62 with at least two ancillary codes for symptoms.
Impact
Lack of detailed symptom documentation can lead to audits.
Mitigation Strategy
Ensure comprehensive documentation of symptoms and treatments.
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 Breast Hypertrophy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Breast Hypertrophy
Use these documentation templates to ensure complete and accurate documentation for Breast Hypertrophy. These templates include all required elements for proper coding and billing.
Breast hypertrophy with chronic pain and intertrigo
Specialty: Plastic SurgeryRequired Elements
- Symptom description
- Physical exam findings
- Failed treatments
- Photographic evidence
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Breast Hypertrophy? Ask your questions below.