ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesR22.3

R22.3

Localized swelling, mass and lump, upper limb

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

Code Description

ICD-10 R22.3 is a billable code used to indicate a diagnosis of localized swelling, mass and lump, upper limb.

Key Diagnostic Point:

Localized swelling, mass, and lump in the upper limb can present as a palpable enlargement or abnormality in the arm or shoulder region. This condition may arise from various underlying causes, including infections, inflammatory processes, benign tumors, or malignancies. Symptoms may include pain, tenderness, and restricted movement in the affected area. Clinical examination often reveals a firm or soft mass, which may be warm to the touch if associated with inflammation or infection. Diagnostic imaging, such as ultrasound or MRI, may be utilized to assess the characteristics of the mass, while laboratory tests can help identify infectious or inflammatory markers. Accurate diagnosis is crucial, as the management and prognosis can vary significantly based on the underlying etiology.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes (benign vs malignant)
  • Need for precise documentation of size and characteristics of the mass
  • Differentiation from similar conditions (e.g., R22.2 for localized swelling in other areas)
  • Potential for co-existing conditions that may complicate coding

Audit Risk Factors

  • Inadequate documentation of the mass characteristics
  • Failure to specify the location accurately
  • Misclassification of benign vs malignant masses
  • Lack of supporting clinical findings or imaging results

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed history of the mass, including onset, duration, and associated symptoms.

Common Clinical Scenarios

Patients presenting with a new lump in the arm, often requiring further evaluation.

Billing Considerations

Consideration of systemic conditions that may contribute to localized swelling.

Emergency Medicine

Documentation Requirements

Acute assessment of the mass, including vital signs and any signs of systemic infection.

Common Clinical Scenarios

Acute presentations of abscesses or traumatic hematomas.

Billing Considerations

Rapid assessment and documentation are crucial for timely intervention.

Coding Guidelines

Inclusion Criteria

Use R22.3 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the swelling, mass, or lump is localized to the upper limb and not due to systemic conditions

Exclusion Criteria

Do NOT use R22.3 When
No specific exclusions found.

Related CPT Codes

88305CPT Code

Pathology examination of tissue

Clinical Scenario

When a biopsy is performed to evaluate a mass in the upper limb.

Documentation Requirements

Document the reason for the biopsy and the characteristics of the mass.

Specialty Considerations

Pathology reports should be linked to the diagnosis for accurate coding.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of localized conditions, improving the granularity of data for clinical and billing purposes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of localized conditions, improving the granularity of data for clinical and billing purposes.

Reimbursement & Billing Impact

billing purposes.

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

What should be documented for R22.3?

Document the size, location, characteristics (e.g., painful, firm), duration, and any associated symptoms of the mass.