D22.4
BillableMelanocytic nevi of scalp and neck
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D22.4 an HCC code?
No. D22.4 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
D22.4 is the ICD-10-CM diagnosis code for melanocytic nevi of scalp and neck. This code describes benign (non-cancerous) moles on the scalp or neck area. These are common skin growths made up of melanocytes (pigment-producing cells) that are typically harmless. D22.4 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering benign neoplasms, except benign neuroendocrine tumors (d10-d36).
D22.4 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Ensure the documentation specifically identifies the lesion as a melanocytic nevus (mole) rather than a melanoma or other skin condition, as this affects code selection.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D22.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure the documentation specifically identifies the lesion as a melanocytic nevus (mole) rather than a melanoma or other skin condition, as this affects code selection
- •Use the 7th character extension to specify laterality (right, left, or bilateral) when applicable, as required by ICD-10-CM guidelines