ICD-10 N64.81
Billable / SpecificPtosis of breast
About ICD-10-CM N64.81
ICD-10-CM code N64.81 represents Ptosis of breast. This is a billable/specific code in the Genitourinary System chapter (block N64). The 2026 edition of ICD-10-CM N64.81 became effective on October 1, 2025.
Type 1 Excludes
Pure excludes, these codes can never be coded together with N64.81. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- ptosis of native breast in relation to reconstructed breast (N65.1)
Medicare LCD Coverage for N64.81
Local Coverage Determinations (LCDs) from CMS MACs that list N64.81 as a covered diagnosis.
Showing top 10 of 216 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing N64.81.
1 Cigna
4 Medicare
CPT Codes Commonly Billed with N64.81
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.
Convert N64.81 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| N64.81 | 61181 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To N64.81
Other codes in section N60-N65 (Disorders of breast).
ICD-10 N64.81, Billing FAQ
Is ICD-10 code N64.81 billable? +
Yes, N64.81 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What codes are Type 1 Excludes for N64.81? +
Type 1 Excludes (never code together with N64.81): ptosis of native breast in relation to reconstructed breast (N65.1)
What ICD-9 codes does N64.81 map to? +
Per CMS GEMs, N64.81 maps to ICD-9 codes: 61181. Useful for legacy data review and historical claim analysis.
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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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