ICD-10 · PDGM grouping
O92 Other disorders of breast and disorders of lactation associated with pregnancy and the puerperium
All 20 codes in the O92 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
20
Can lead a claim
16
Cannot lead a claim
4
What CMS assigns to O92
16 of the 20 codes group to MMTA - Other; 4 are assigned no clinical group. None of the 20 is assigned a comorbidity subgroup. 16 of the 20 can lead a claim.
Every code in O92
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 |
|---|---|---|---|---|
| O92.0 Retracted nipple associated with pregnancy, the puerperium, and lactation | ||||
| O92.01 Retracted nipple associated with pregnancy | ||||
| O92.011 | Retracted nipple associated with pregnancy, first trimester | Can lead a claim | A | None |
| O92.012 | Retracted nipple associated with pregnancy, second trimester | Can lead a claim | A | None |
| O92.013 | Retracted nipple associated with pregnancy, third trimester | Can lead a claim | A | None |
| O92.019 | Retracted nipple associated with pregnancy, unspecified trimesterCMS: Retracted nipple associated with pregnancy, unsp trimester | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| O92.02 | Retracted nipple associated with the puerperium | Can lead a claim | A | None |
| O92.03 | Retracted nipple associated with lactation | Can lead a claim | A | None |
| O92.1 Cracked nipple associated with pregnancy, the puerperium, and lactation | ||||
| O92.11 Cracked nipple associated with pregnancy | ||||
| O92.111 | Cracked nipple associated with pregnancy, first trimester | Can lead a claim | A | None |
| O92.112 | Cracked nipple associated with pregnancy, second trimester | Can lead a claim | A | None |
| O92.113 | Cracked nipple associated with pregnancy, third trimester | Can lead a claim | A | None |
| O92.119 | Cracked nipple associated with pregnancy, unspecified trimesterCMS: Cracked nipple associated with pregnancy, unsp trimester | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| O92.12 | Cracked nipple associated with the puerperium | Can lead a claim | A | None |
| O92.13 | Cracked nipple associated with lactation | Can lead a claim | A | None |
| O92.2 Other and unspecified disorders of breast associated with pregnancy and the puerperium | ||||
| O92.20 | Unspecified disorder of breast associated with pregnancy and the puerperiumCMS: Unsp disorder of breast assoc w pregnancy and the puerperium | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| O92.29 | Other disorders of breast associated with pregnancy and the puerperiumCMS: Oth disorders of breast assoc w pregnancy and the puerperium | Can lead a claim | A | None |
| O92.3 | Agalactia | Can lead a claim | A | None |
| O92.4 | Hypogalactia | Can lead a claim | A | None |
| O92.5 | Suppressed lactation | Can lead a claim | A | None |
| O92.6 | Galactorrhea | Can lead a claim | A | None |
| O92.7 Other and unspecified disorders of lactation | ||||
| O92.70 | Unspecified disorders of lactation | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| O92.79 | Other disorders of lactation | 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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