ICD-10 · PDGM grouping
N63 Unspecified lump in breast
All 17 codes in the N63 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
17
Can lead a claim
16
Cannot lead a claim
1
What CMS assigns to N63
16 of the 17 codes group to MMTA - Other; 1 is assigned no clinical group. None of the 17 is assigned a comorbidity subgroup. 16 of the 17 can lead a claim.
Every code in N63
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| N63.0 | Unspecified lump in unspecified breast | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| N63.1 Unspecified lump in the right breast | ||||
| N63.10 | Unspecified lump in the right breast, unspecified quadrant | Can lead a claim | A | None |
| N63.11 | Unspecified lump in the right breast, upper outer quadrant | Can lead a claim | A | None |
| N63.12 | Unspecified lump in the right breast, upper inner quadrant | Can lead a claim | A | None |
| N63.13 | Unspecified lump in the right breast, lower outer quadrant | Can lead a claim | A | None |
| N63.14 | Unspecified lump in the right breast, lower inner quadrant | Can lead a claim | A | None |
| N63.15 | Unspecified lump in the right breast, overlapping quadrants | Can lead a claim | A | None |
| N63.2 Unspecified lump in the left breast | ||||
| N63.20 | Unspecified lump in the left breast, unspecified quadrant | Can lead a claim | A | None |
| N63.21 | Unspecified lump in the left breast, upper outer quadrant | Can lead a claim | A | None |
| N63.22 | Unspecified lump in the left breast, upper inner quadrant | Can lead a claim | A | None |
| N63.23 | Unspecified lump in the left breast, lower outer quadrant | Can lead a claim | A | None |
| N63.24 | Unspecified lump in the left breast, lower inner quadrant | Can lead a claim | A | None |
| N63.25 | Unspecified lump in the left breast, overlapping quadrants | Can lead a claim | A | None |
| N63.3 Unspecified lump in axillary tail | ||||
| N63.31 | Unspecified lump in axillary tail of the right breast | Can lead a claim | A | None |
| N63.32 | Unspecified lump in axillary tail of the left breast | Can lead a claim | A | None |
| N63.4 Unspecified lump in breast, subareolar | ||||
| N63.41 | Unspecified lump in right breast, subareolar | Can lead a claim | A | None |
| N63.42 | Unspecified lump in left breast, subareolar | Can lead a claim | A | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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