Abscess of breast associated with lactation

This code signifies a localized collection of pus within the breast tissue that develops during the period of lactation. It is a complication of mastitis, often resulting from untreated or inadequately treated breast infection in a breastfeeding individual. The abscess formation is a distinct, more severe stage of infection.

Apply this code when documentation clearly indicates the presence of a breast abscess in a patient who is currently lactating or has recently lactated. Supporting documentation should include physical exam findings (e.g., palpable mass, erythema, tenderness, fluctuance), imaging results confirming an abscess (e.g., ultrasound), and a clear association with the lactation period.

• Ensure the documentation explicitly states "abscess" and not just "mastitis" to differentiate from O91.12 (Nonpurulent mastitis associated with lactation).
• Verify the patient's lactation status; this code is specific to lactation-associated abscesses.
• Consider sequencing this code as the primary diagnosis if it is the main reason for the encounter, followed by codes for any underlying conditions or complications.