ICD-10 Coding for Diffuse Cyst Bilateral Breast(N60.11, N60.12)
Complete ICD-10-CM coding and documentation guide for Diffuse Cyst Bilateral Breast. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diffuse Cyst Bilateral Breast
N60.0-N60.9Primary Range
Benign mammary dysplasia
This range includes codes for various benign breast conditions, including diffuse cystic mastopathy.
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 of right breast | Use when diffuse cystic mastopathy is confirmed in the right breast. |
|
| N60.12 | Diffuse cystic mastopathy of left breast | Use when diffuse cystic mastopathy is 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 diffuse cystic mastopathy bilateral
Essential facts and insights about Diffuse Cyst Bilateral Breast
Primary ICD-10-CM Codes for diffuse cyst bilateral breast
Decision Criteria
clinical Criteria
- Confirmed diffuse cystic changes in the right breast
Applicable To
- Diffuse cystic changes in the right breast
Excludes
- Fibroadenosis (N60.2)
Clinical Validation Requirements
- Ultrasound showing multiple cysts in the right breast
- BI-RADS 2 or 3 classification
Code-Specific Risks
- Risk of using unspecified codes when laterality is documented.
Coding Notes
- Ensure laterality is specified in documentation.
N60.12 - Diffuse cystic mastopathy of left breast
Use when diffuse cystic mastopathy is confirmed in the left breast.
Applicable To
- Diffuse cystic changes in the left breast
Excludes
- Fibroadenosis (N60.2)
Clinical Validation Requirements
- Ultrasound showing multiple cysts in the left breast
- BI-RADS 2 or 3 classification
Coding Notes
Ensure laterality is specified in documentation.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Breast pain
R07.81Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Fibroadenosis of breast
N60.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Diffuse Cyst Bilateral Breast 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 misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Use precise terminology like 'diffuse cystic mastopathy'.
Impact
Reimbursement: May lead to incorrect DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces specificity and accuracy of data.
Mitigation Strategy
Ensure to code both N60.11 and N60.12 for bilateral cases.
Impact
Failure to document laterality can lead to incorrect coding.
Mitigation Strategy
Implement a checklist to ensure laterality is always documented.
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 Diffuse Cyst Bilateral Breast, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diffuse Cyst Bilateral Breast
Use these documentation templates to ensure complete and accurate documentation for Diffuse Cyst Bilateral Breast. These templates include all required elements for proper coding and billing.
Bilateral diffuse cystic mastopathy
Specialty: RadiologyRequired Elements
- History of cyclical breast pain
- Ultrasound findings
- BI-RADS classification
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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