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v1.0.0
ICD-10 Guide
ICD-10 CodesR21

R21

Rash and other nonspecific skin eruption

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R21 is a billable code used to indicate a diagnosis of rash and other nonspecific skin eruption.

Key Diagnostic Point:

R21 is used to classify a variety of skin eruptions that are nonspecific in nature, meaning they do not fit neatly into other defined categories of skin conditions. These rashes can present as erythematous, papular, vesicular, or maculopapular lesions and may be associated with pruritus (itching), burning, or discomfort. The etiology of these rashes can be diverse, including allergic reactions, infections, autoimmune conditions, or irritant contact dermatitis. Clinical evaluation often involves a thorough history and physical examination to identify potential triggers or associated symptoms. Laboratory tests may be warranted to rule out infectious or systemic causes. Due to the nonspecific nature of R21, it is crucial for healthcare providers to document the clinical context, including duration, location, and associated symptoms, to guide appropriate management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes
  • Overlap with other skin conditions
  • Need for thorough documentation
  • Potential for misclassification

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify associated symptoms
  • Misuse of R21 when a more specific code is available
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed history of the rash, including onset, duration, and associated symptoms. Document any relevant past medical history and medications.

Common Clinical Scenarios

Patients presenting with generalized rash without a clear etiology, often requiring further investigation.

Billing Considerations

Consider potential systemic causes and document any laboratory findings that may support the diagnosis.

Emergency Medicine

Documentation Requirements

Acute assessment of the rash, including vital signs and any immediate interventions. Document any potential allergic reactions or anaphylaxis.

Common Clinical Scenarios

Patients presenting with acute rash and associated symptoms such as difficulty breathing or swelling.

Billing Considerations

Rapid assessment is critical; ensure documentation reflects urgency and any treatments administered.

Coding Guidelines

Inclusion Criteria

Use R21 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is supported by clinical documentation
  • R21 should be used when no other specific diagnosis is applicable, and the clinical context is well
  • documented

Exclusion Criteria

Do NOT use R21 When
No specific exclusions found.

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used when a patient presents with a nonspecific rash requiring evaluation and management.

Documentation Requirements

Document the history, examination findings, and any treatment provided.

Specialty Considerations

Ensure that the visit level reflects the complexity of the case.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of skin conditions, but R21 remains a broad category that requires careful documentation to avoid misclassification.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of skin conditions, but R21 remains a broad category that requires careful documentation to avoid misclassification.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more detailed coding of skin conditions, but R21 remains a broad category that requires careful documentation to avoid misclassification.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

When should I use R21 instead of a more specific code?

Use R21 when the rash is nonspecific and does not fit into any other defined categories. Ensure that the clinical documentation supports the use of this code.