Coding and coverage · ICD-10-CM

N64

N64.5 Other signs and symptoms in breast

Not billable (header)Chapter 14

Report one of the more specific codes below.

Check coverage with this diagnosis

Codes under this one

Instructional notes

Chapter 14

Excludes2Not included here: the patient may have both; report both when both are present.
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Section N60-N65

Excludes1Not coded here: never report with this code, except when the two conditions are unrelated.
  • disorders of breast associated with childbirth (O91-O92)

N64

Excludes2Not included here: the patient may have both; report both when both are present.
  • mechanical complication of breast prosthesis and implant (T85.4-)

This code

Excludes2Not included here: the patient may have both; report both when both are present.
  • abnormal findings on diagnostic imaging of breast (R92.-)

Chapter 14: Diseases of the genitourinary system · N60-N65 Disorders of breast (N60-N65)

Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.

Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.