ICD-10 Coding for Left Breast Cyst(N60.02, N60.12, N63.2)
Complete ICD-10-CM coding and documentation guide for Left Breast Cyst. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left Breast Cyst
N60-N64Primary Range
Disorders of breast
This range includes codes for 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 |
|---|---|---|---|
| N60.02 | Solitary cyst of left breast | Use when imaging confirms a single cyst in the left breast. |
|
| N60.12 | Diffuse cystic mastopathy of left breast | Use when imaging confirms multiple cysts in the left breast. |
|
| N63.2 | Unspecified lump in left breast | Use when the lump is not yet confirmed as a cyst. |
|
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 left breast cyst
Essential facts and insights about Left Breast Cyst
Primary ICD-10-CM Codes for left breast cyst
Decision Criteria
clinical Criteria
- Confirmed solitary cyst via imaging
documentation Criteria
- Documentation must specify 'solitary cyst' and laterality
Applicable To
- Single fluid-filled lesion in left breast
Clinical Validation Requirements
- Ultrasound confirmation of solitary cyst
- Anechoic with posterior enhancement
Code-Specific Risks
- Incorrectly coding multiple cysts as solitary
Coding Notes
- Ensure imaging confirms solitary nature before using this code.
N60.12 - Diffuse cystic mastopathy of left breast
Use when imaging confirms multiple cysts in the left breast.
Applicable To
- Multiple cysts in left breast
Excludes
- Solitary cyst (N60.02)
- Benign neoplasm of breast (D24.1)
Clinical Validation Requirements
- Imaging showing multiple cysts
- Diffuse cystic changes
Coding Notes
Ensure documentation specifies multiple cysts.
N63.2 - Unspecified lump in left breast
Use when the lump is not yet confirmed as a cyst.
Applicable To
- Palpable mass in left breast
Excludes
- Confirmed cyst (N60.02, N60.12)
Clinical Validation Requirements
- Physical exam noting lump
- Pending imaging results
Coding Notes
Use as a placeholder until further diagnostic confirmation.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Left Breast Cyst to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N60.02.
Impact
Clinical: Ambiguity in patient records., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always document left or right breast, Use templates with laterality prompts
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use N60.12 for multiple cysts in the left breast.
Impact
Using incorrect codes for breast cysts can lead to audits.
Mitigation Strategy
Ensure thorough documentation and correct code selection.
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 Left Breast Cyst, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left Breast Cyst
Use these documentation templates to ensure complete and accurate documentation for Left Breast Cyst. These templates include all required elements for proper coding and billing.
Ultrasound-confirmed solitary cyst
Specialty: RadiologyRequired Elements
- Laterality
- Cyst size
- Cyst characteristics
- BI-RADS category
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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