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N61.1

Billable

Abscess of the breast and nipple

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

A collection of pus in the breast tissue, typically caused by infection. This condition presents with localized pain, swelling, and may require drainage or antibiotics.

Coding Tips

  • Confirm the presence of an abscess through imaging (ultrasound or MRI) before coding; clinical suspicion alone is insufficient
  • Document laterality and whether the abscess involves the breast tissue or nipple area

Code Hierarchy

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