ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 N61.22

Billable / Specific

Granulomatous mastitis, left breast

N61
Block
0
Synonyms
18
LCDs
2
Payer Policies
0
Linked CPTs

About ICD-10-CM N61.22

ICD-10-CM code N61.22 represents Granulomatous mastitis, left breast. This is a billable/specific code in the Genitourinary System chapter (block N61). The 2026 edition of ICD-10-CM N61.22 became effective on October 1, 2025.

Medicare LCD Coverage for N61.22

Local Coverage Determinations (LCDs) from CMS MACs that list N61.22 as a covered diagnosis.

18 LCDs

Showing top 10 of 18 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 77063 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT C8905 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 77065 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 76641 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 77054 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 77047 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 77049 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT C8903 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT C8906 →
CMS LCD: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Article ID: 56448, Effective: 2025-12-04 00:00:00, 156 covered, 0 non-covered
CPT 77066 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing N61.22.

2 policies

1 Cigna

Transvaginal Ultrasound, Non-Obstetrical - (0398)
Policy ID: MM_0398

1 Medicare

Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
Policy ID: ART-56448

CPT Codes Commonly Billed with N61.22

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for N61.22

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.

ICD-10 N61.22, Billing FAQ

Is ICD-10 code N61.22 billable? +

Yes, N61.22 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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