ICD-10 O91.22
Billable / SpecificNonpurulent mastitis associated with the puerperium
About ICD-10-CM O91.22
ICD-10-CM code O91.22 represents Nonpurulent mastitis associated with the puerperium. This is a billable/specific code in the Pregnancy, Childbirth, and Puerperium chapter (block O91). The 2026 edition of ICD-10-CM O91.22 became effective on October 1, 2025.
Coding Tips for O91.22
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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under O91.22. Per CMS ICD-10-CM Tabular 2026.
- Puerperal interstitial mastitis
- Puerperal lymphangitis of breast
- Puerperal mastitis NOS
- Puerperal parenchymatous mastitis
Medicare LCD Coverage for O91.22
Local Coverage Determinations (LCDs) from CMS MACs that list O91.22 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 O91.22.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but O91.22 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with O91.22
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 O91.22 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 |
|---|---|---|
| O91.22 | 67522 | 10000 |
| O91.22 | 67524 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To O91.22
Other codes in section O85-O92 (Complications predominantly related to the puerperium).
ICD-10 O91.22, Billing FAQ
Is ICD-10 code O91.22 billable? +
Yes, O91.22 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to O91.22? +
ICD-10 O91.22 includes: Puerperal interstitial mastitis; Puerperal lymphangitis of breast; Puerperal mastitis NOS, and 1 more clinical synonyms.
What ICD-9 codes does O91.22 map to? +
Per CMS GEMs, O91.22 maps to ICD-9 codes: 67522, 67524. 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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