N61.1 — Abscess of the breast and nipple
Is N61.1 billable?
Yes — N61.1 is billable for FY2027. N61.1 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. N61.1 may be submitted for encounters from October 1, 2026 through September 30, 2027.
N61.1 at a glance
| Code | N61.1 |
|---|---|
| Description | Abscess of the breast and nipple |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does N61.1 group to?
N61.1 sits in MDC 09 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 600Non-Malignant Breast Disorders with CC/MCCmedical
- 601Non-Malignant Breast Disorders without CC/MCCmedical
How is N61.1 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to N61.1. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Abscess › areola (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic)
- Abscess › breast (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic)
- Abscess › nipple (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic)
- Carbuncle › breast
- Furuncle › breast
- Mastitis › with abscess (acute) (diffuse) (nonpuerperal) (subacute)
- Suppuration, suppurative › breast
- Suppuration, suppurative › mammary gland
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative › breast
Inclusion terms
Alternative wording in documentation that is classified to N61.1.
- Abscess (acute) (chronic) (nonpuerperal) of areola
- Abscess (acute) (chronic) (nonpuerperal) of breast
- Carbuncle of breast
- Mastitis with abscess
Excludes1 — never code together — inherited from N60-N65
The conditions below can never be reported together with N61.1 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- disorders of breast associated with childbirth (O91-O92)
Excludes1 — never code together — inherited from N61
The conditions below can never be reported together with N61.1 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Excludes2 — not included here — inherited from Chapter 14
The conditions below are not part of N61.1, but a patient may have both at the same time. When documentation supports it, N61.1 and the excluded code may both be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
How long has N61.1 existed?
N61.1 first appears in FY2018 (FY2017 is not available, so it may have appeared then).
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.