N60.31: Fibrosclerosis of right breast
N60.31, fibrosclerosis of right breast, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 8 HCPCS Level II codes, including C8903 (Magnetic resonance imaging with contrast, breast; unilateral), C8905 (Magnetic resonance imaging without contrast followed by…), C8906 (Magnetic resonance imaging with contrast, breast; bilateral). The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with N60.31 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| C8903 | Magnetic resonance imaging with contrast, breast; unilateral | Special coverage instructions apply | — | 2 |
| C8905 | Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral | Special coverage instructions apply | — | 2 |
| C8906 | Magnetic resonance imaging with contrast, breast; bilateral | Special coverage instructions apply | — | 2 |
| C8908 | Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral | Special coverage instructions apply | — | 2 |
| Q2028 | Injection, sculptra, 0.5 mg | Special coverage instructions apply | — | 2 |
| G0429 | Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy) | Carrier judgment | — | 2 |
| Q2026 | Injection, radiesse, 0.1 ml | Special coverage instructions apply | — | 2 |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | Carrier judgment | — | 1 |
Medicare policy articles listing N60.31
- A52849: Billing and Coding: Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography (Wellpoint Federal (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L33585
- A56448: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L33950
- A59299: Billing and Coding: Cosmetic and Reconstructive Surgery (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33428, L35090, L38914, L39051
- A58774: Billing and Coding: Cosmetic and Reconstructive Surgery (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33428, L35090, L38914, L39051
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other N60 diagnoses (Benign mammary dysplasia)
- N60.32 — Fibrosclerosis of left breast
- N60.01 — Solitary cyst of right breast
- N60.02 — Solitary cyst of left breast
- N60.11 — Diffuse cystic mastopathy of right breast
- N60.12 — Diffuse cystic mastopathy of left breast
- N60.21 — Fibroadenosis of right breast
- N60.22 — Fibroadenosis of left breast
- N60.41 — Mammary duct ectasia of right breast
- N60.42 — Mammary duct ectasia of left breast
- N60.81 — Other benign mammary dysplasias of right breast
- N60.82 — Other benign mammary dysplasias of left breast
Frequently asked questions
Does Medicare cover N60.31 (Fibrosclerosis of right breast)?
Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list N60.31 as a covered diagnosis for 8 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 N60.31?
The Level II codes from the policies most specific to this diagnosis are C8903 (Magnetic resonance imaging with contrast, breast; unilateral, 2 articles); C8905 (Magnetic resonance imaging without contrast followed by…, 2 articles); C8906 (Magnetic resonance imaging with contrast, breast; bilateral, 2 articles); C8908 (Magnetic resonance imaging without contrast followed by…, 2 articles); Q2028 (Injection, sculptra, 0.5 mg, 2 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list N60.31?
A52849 (Billing and Coding: Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography); A56448 (Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography); A59299 (Billing and Coding: Cosmetic and Reconstructive Surgery), and 1 more article.
What is ICD-10-CM code N60.31?
N60.31 is the ICD-10-CM code for fibrosclerosis of right breast, in category N60 (Benign mammary dysplasia), chapter 14: Diseases of the genitourinary system.
Next steps
- Run a reimbursement report for a device billed under C8903
- Watch C8903 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for C8903
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 14: Diseases of the genitourinary system · All diagnoses · HCPCS lookup