O91.113

Abscess of breast associated with pregnancy, third trimester

FY2027Chapter 15: Pregnancy, childbirth and the puerperium/O85–O92 Complications predominantly related to the puerperium

BillableComplete code, valid to report

O91.113 (also written O91113) is a billable ICD-10-CM diagnosis code for abscess of breast associated with pregnancy, third trimester. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 18 codes in category O91 (Infections of breast associated with pregnancy, the puerperium and lactation). Its coding notes include a Use additional code instruction, 1 Excludes1 entry and 7 Excludes2 entries.

Guidelines tip

From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.

The trimester character comes from the provider's documentation for the current encounter. The unspecified trimester code should rarely be used.

Guidelines I.C.15.a.3; I.C.15.a.5Pregnancy: the trimester characterRead the official text

Use additional code

Add the listed code as a secondary code, if known.

Inherited from O91 Infections of breast associated with pregnancy, the puerperium and lactation
  • code to identify infection
Also from chapter/block level (1 note)
Inherited from Chapter 15 Pregnancy, childbirth and the puerperium
  • code, if applicable, from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.

Excludes1

Not coded here. The listed conditions generally should not be reported together.

Also from chapter/block level (1 note)
Inherited from Chapter 15 Pregnancy, childbirth and the puerperium
  • supervision of normal pregnancy (Z34.-)

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Also from chapter/block level (7 notes)
Inherited from O85–O92 Complications predominantly related to the puerperium
  • mental and behavioral disorders associated with the puerperium (F53.-)
  • obstetrical tetanus (A34)
  • puerperal osteomalacia (M83.0)
Inherited from Chapter 15 Pregnancy, childbirth and the puerperium
  • mental and behavioral disorders associated with the puerperium (F53.-)
  • obstetrical tetanus (A34)
  • postpartum necrosis of pituitary gland (E23.0)
  • puerperal osteomalacia (M83.0)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the Wound clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

Notes

Also from chapter/block level (6 notes)
Inherited from Chapter 15 Pregnancy, childbirth and the puerperium
  • CODES FROM THIS CHAPTER ARE FOR USE ONLY ON MATERNAL RECORDS, NEVER ON NEWBORN RECORDS
  • Codes from this chapter are for use for conditions related to or aggravated by the pregnancy, childbirth, or by the puerperium (maternal causes or obstetric causes)
  • Trimesters are counted from the first day of the last menstrual period. They are defined as follows:
    • 1st trimester- less than 14 weeks 0 days
    • 2nd trimester- 14 weeks 0 days to less than 28 weeks 0 days
    • 3rd trimester- 28 weeks 0 days until delivery