Symptoms and signs involving the skin and subcutaneous tissue
ICD-10 Codes (24)
R21R22R22.0R22.1R22.2R22.3R22.30R22.31R22.32R22.33R22.4R22.40R22.41R22.42R22.43R22.9R23R23.0R23.1R23.2R23.3R23.4R23.8R23.9Updates & Changes
FY 2026 Updates
Deleted Codes
No codes deleted in this range for FY 2026
No significant changes for FY 2026
This range maintains stability with current coding practices
Historical Changes
- •FY 2025: Routine maintenance updates with minor terminology clarifications
- •FY 2024: Enhanced specificity requirements for certain code ranges
- •FY 2023: Updated documentation guidelines for improved clarity
Upcoming Changes
- •Proposed updates pending review by Coordination and Maintenance Committee
- •Under consideration: Enhanced digital health integration codes
Implementation Guidance
- •Review all FY 2026 updates for R20-R23 codes before implementation
- •Always verify the most current codes in the ICD-10-CM manual
- •Ensure clinical documentation supports the selected diagnosis codes
- +3 more guidance items...
Range Overview
The ICD-10 code range R20-R23 represents symptoms and signs involving the skin and subcutaneous tissue. These codes are used to document various skin-related symptoms such as hypersensitivity, pruritus, and changes in skin texture. They also cover localized swelling, mass and lump of skin and subcutaneous tissue. These codes are crucial for accurate medical documentation and billing, and can be used across a wide range of medical specialties.
Key Usage Points:
- •R20-R23 codes are used to document skin-related symptoms and signs.
- •These codes cover a wide range of symptoms, from hypersensitivity to localized swelling.
- •R20-R23 codes can be used in many medical specialties.
- •Always code to the highest level of specificity within this range.
- •Ensure that the code selected accurately reflects the patient's medical record.
Coding Guidelines
When to Use:
- ✓When a patient presents with skin hypersensitivity.
- ✓When a patient reports pruritus or itching.
- ✓When a patient has changes in skin texture.
- ✓When a patient has localized swelling, mass or lump in skin or subcutaneous tissue.
- ✓When a patient has other skin changes.
When NOT to Use:
- ✗When a more specific code is available.
- ✗When the condition is not documented in the medical record.
- ✗When the condition is not relevant to the current medical encounter.
- ✗When the condition is an integral part of another condition.
Code Exclusions
Always verify exclusions by cross-referencing the patient's medical record and the ICD-10 manual.
Documentation Requirements
Documentation for the R20-R23 code range should clearly describe the patient's skin symptoms or signs. It should include the location, severity, and any relevant factors such as triggers or alleviating factors. The patient's response to treatment should also be documented.
Clinical Information:
- •Description of the skin symptom or sign.
- •Location of the symptom or sign.
- •Severity of the symptom or sign.
- •Relevant factors such as triggers or alleviating factors.
- •Patient's response to treatment.
Supporting Evidence:
- •Clinical examination findings.
- •Laboratory test results.
- •Imaging results.
- •Consultation notes.
Good Documentation Example:
Patient presents with severe pruritus on the lower legs, exacerbated by heat and relieved by cold compresses. Examination reveals erythema and excoriations. Topical steroid prescribed with some relief reported.
Poor Documentation Example:
Patient has itchy skin.
Common Documentation Errors:
- ⚠Not documenting the location of the symptom or sign.
- ⚠Not documenting the severity of the symptom or sign.
- ⚠Not documenting relevant factors such as triggers or alleviating factors.
- ⚠Not documenting the patient's response to treatment.
Range Statistics
Coding Complexity
The R20-R23 code range has a medium level of complexity due to the need to select the correct code for the symptom or sign, determine the correct level of specificity, understand the clinical context, navigate exclusions, and ensure the code accurately reflects the medical record.
Key Factors:
- ▸Determining the correct level of specificity.
- ▸Identifying the correct code for the symptom or sign.
- ▸Understanding the clinical context.
- ▸Navigating exclusions.
- ▸Ensuring the code accurately reflects the medical record.
Specialty Focus
The R20-R23 code range is particularly relevant to dermatology, but can be used in many other specialties such as internal medicine, family medicine, and pediatrics. These codes are often used to document symptoms and signs that are part of the patient's clinical picture but may not be the primary reason for the encounter.
Primary Specialties:
Clinical Scenarios:
- • A patient presents with pruritus of unknown origin.
- • A patient has localized swelling of the skin following an insect bite.
- • A patient reports changes in skin texture, such as dryness or roughness.
- • A patient has a lump in the subcutaneous tissue of the arm.
- • A patient has hypersensitivity in the skin following exposure to a new detergent.
Resources & References
There are many resources available to help with coding in the R20-R23 range. The ICD-10 manual is the primary resource, but there are also coding handbooks, online resources, and training courses available.
Official Guidelines:
- ICD-10-CM Official Guidelines for Coding and Reporting
- American Health Information Management Association (AHIMA) Coding Handbook
- American Academy of Professional Coders (AAPC) ICD-10 Training
- Centers for Medicare & Medicaid Services (CMS) ICD-10 Resources
Clinical References:
- UpToDate Clinical Database
- Medscape Reference
- American Academy of Dermatology Guidelines
Educational Materials:
- AAPC ICD-10 Training
- AHIMA ICD-10 Training
- ICD10Data.com
Frequently Asked Questions
Can R20-R23 codes be used as primary diagnosis codes?
Yes, R20-R23 codes can be used as primary diagnosis codes when the skin symptom or sign is the reason for the encounter.
What is the level of specificity required for R20-R23 codes?
Always code to the highest level of specificity within the R20-R23 range. This means selecting the code that most accurately reflects the patient's medical record.