ICD-10 O91.213
Billable / SpecificNonpurulent mastitis associated with pregnancy, third trimester
About ICD-10-CM O91.213
ICD-10-CM code O91.213 represents Nonpurulent mastitis associated with pregnancy, third trimester. This is a billable/specific code in the Pregnancy, Childbirth, and Puerperium chapter (block O91). The 2026 edition of ICD-10-CM O91.213 became effective on October 1, 2025.
Coding Tips for O91.213
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
Most O codes require a 7th character indicating trimester (1 = first, 2 = second, 3 = third). Some require fetus identification character. Code O09 (supervision of high-risk pregnancy) is required as a secondary code when applicable.
Medicare LCD Coverage for O91.213
Local Coverage Determinations (LCDs) from CMS MACs that list O91.213 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 O91.213.
4 Medicare
CPT Codes Commonly Billed with O91.213
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 O91.213 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 |
|---|---|---|
| O91.213 | 67521 | 10000 |
| O91.213 | 67523 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To O91.213
Other codes in section O85-O92 (Complications predominantly related to the puerperium).
ICD-10 O91.213, Billing FAQ
Is ICD-10 code O91.213 billable? +
Yes, O91.213 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What ICD-9 codes does O91.213 map to? +
Per CMS GEMs, O91.213 maps to ICD-9 codes: 67521, 67523. 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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