ICD-10 Guide

R23.4

Changes in skin texture

BILLABLE STATUSYes

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/11/2025

Code Description

ICD-10 R23.4 is a billable code used to indicate a diagnosis of changes in skin texture.

Key Diagnostic Point:

Changes in skin texture refer to alterations in the surface characteristics of the skin, which may manifest as roughness, smoothness, thickening, or thinning. These changes can be indicative of various underlying conditions, including dermatological disorders, systemic diseases, or environmental factors. Clinically, patients may present with symptoms such as dryness, scaling, or a leathery appearance of the skin. Common causes include eczema, psoriasis, contact dermatitis, and chronic sun exposure. In some cases, changes in skin texture may also be associated with metabolic disorders or nutritional deficiencies. A thorough clinical evaluation, including a detailed history and physical examination, is essential to determine the underlying cause. Laboratory tests may be warranted to rule out systemic conditions, and a biopsy may be necessary for definitive diagnosis in certain cases. Accurate documentation of the patient's symptoms, duration, and any associated factors is crucial for appropriate coding and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

Variability in presentation and underlying causes
Need for comprehensive patient history and examination
Potential overlap with other dermatological codes
Documentation requirements for specificity

Audit Risk Factors

Inadequate documentation of symptoms and history
Misclassification with other skin conditions
Failure to specify the underlying cause
Lack of supporting clinical findings

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed patient history, including onset, duration, and associated symptoms; physical examination findings; and any relevant lab results.

Common Clinical Scenarios

Patients presenting with chronic skin changes, often associated with systemic conditions such as diabetes or thyroid disorders.

Billing Considerations

Consider the impact of comorbidities on skin texture changes and document any relevant systemic findings.

Emergency Medicine

Documentation Requirements

Acute assessment of skin changes, including rapid evaluation of associated symptoms such as pain, itching, or systemic signs.

Common Clinical Scenarios

Acute allergic reactions or infections presenting with sudden changes in skin texture.

Billing Considerations

Document any immediate interventions and the patient's response to treatment.

Coding Guidelines

Inclusion Criteria

Use R23.4 When

Follow official ICD
10 coding guidelines, ensuring specificity in documentation and linking to the appropriate clinical findings
Use additional codes as necessary to capture underlying conditions

Exclusion Criteria

Do NOT use R23.4 When

No specific exclusions found.

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits where skin texture changes are assessed.

Documentation Requirements

Document the patient's history, examination findings, and any treatment plans.

Specialty Considerations

Ensure that the visit is appropriately linked to the diagnosis of skin texture changes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of skin conditions, improving the ability to capture the nuances of changes in skin texture and their underlying causes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of skin conditions, improving the ability to capture the nuances of changes in skin texture and their underlying causes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of skin conditions, improving the ability to capture the nuances of changes in skin texture and their underlying causes.

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 to support the use of R23.4?

Document the patient's symptoms, duration of changes, associated factors, and any relevant clinical findings or treatments to support the diagnosis.

ICD-10 R23.4 is a billable code used to indicate a diagnosis of changes in skin texture.