ICD-10 N61
Non-Billable HeaderInflammatory disorders of breast
About ICD-10-CM N61
ICD-10-CM code N61 represents Inflammatory disorders of breast. This is a non-billable header code in the Genitourinary System chapter (block N61). The 2026 edition of ICD-10-CM N61 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with N61. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- inflammatory carcinoma of breast (C50.A-)
- inflammatory disorder of breast associated with childbirth (O91.-)
- neonatal infective mastitis (P39.0)
- thrombophlebitis of breast [Mondor's disease] (I80.8)
Medicare LCD Coverage for N61
Local Coverage Determinations (LCDs) from CMS MACs that list N61 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing N61.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but N61 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with N61
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To N61
Other codes in section N60-N65 (Disorders of breast).
ICD-10 N61, Billing FAQ
Is ICD-10 code N61 billable? +
No, N61 is a non-billable header code. Use a more specific child code from block N61 when submitting claims.
What codes are Type 1 Excludes for N61? +
Type 1 Excludes (never code together with N61): inflammatory carcinoma of breast (C50.A-); inflammatory disorder of breast associated with childbirth (O91.-); neonatal infective mastitis (P39.0)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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