R22.1 ICD-10-CM Code: Localized swelling, mass and lump, neck
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FY 2026 Apr update / Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) / Symptoms and signs involving the skin and subcutaneous tissue (R20-R23)
R22.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceLocalized swelling, mass and lump, neck
A localized area of swelling, bulge, or lump felt or seen on the neck, which may indicate enlarged lymph nodes, thyroid issues, or other conditions.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for R22.1 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for R22.1 in this effective period.
Related Child Codes
Includes
Official- subcutaneous nodules (localized)(superficial)
Excludes 1
Official- abnormal findings on diagnostic imaging (R90-R93)
- edema (R60.-)
- enlarged lymph nodes (R59.-)
- localized adiposity (E65)
- swelling of joint (M25.4-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for R22.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for R22.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for R22.1 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is R22.1 an HCC code?
No. R22.1 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
R22.1 is the ICD-10-CM diagnosis code for localized swelling, mass and lump, neck. A localized area of swelling, bulge, or lump felt or seen on the neck, which may indicate enlarged lymph nodes, thyroid issues, or other conditions. R22.1 sits in the ICD-10-CM chapter for symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (r00-r99), within the section covering symptoms and signs involving the skin and subcutaneous tissue (r20-r23).
R22.1 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.
Specify the exact location in the neck (anterior, posterior, lateral) and whether it is unilateral or bilateral.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R22.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Specify the exact location in the neck (anterior, posterior, lateral) and whether it is unilateral or bilateral
- •If the swelling is identified as a specific condition (lymphadenopathy, thyroid nodule, etc.), use the more specific diagnostic code