N63.22 ICD-10-CM Code: Unspecified lump in the left breast, upper inner quadrant
HCC Buddy Code Card
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FY 2026 Apr update / Diseases of the genitourinary system (N00-N99) / Disorders of breast (N60-N65)
N63.22
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceUnspecified lump in the left breast, upper inner quadrant
A lump or mass found in the upper inner area of the left breast, closer to the center of the chest.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for N63.22 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for N63.22 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for N63.22 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for N63.22 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for N63.22 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for N63.22 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for N63.22 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is N63.22 an HCC code?
No. N63.22 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
N63.22 is the ICD-10-CM diagnosis code for unspecified lump in the left breast, upper inner quadrant. A lump or mass found in the upper inner area of the left breast, closer to the center of the chest. N63.22 sits in the ICD-10-CM chapter for diseases of the genitourinary system (n00-n99), within the section covering disorders of breast (n60-n65).
N63.22 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
The upper inner quadrant is also called the upper medial quadrant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for N63.22 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •The upper inner quadrant is also called the upper medial quadrant
- •Verify the quadrant location is clearly documented in clinical notes or imaging reports