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R22.3 ICD-10-CM Code: Localized swelling, mass and lump, upper limb

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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)

R22.3

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Localized swelling, mass and lump, upper limb

Localized swelling, mass and lump, upper limb

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
R22Localized swelling, mass and lump of skin and subcutaneous tissue
R22.3Localized swelling, mass and lump, upper limb

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for R22.3 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for R22.3 in this effective period.

Related Child Codes

Official
R22.30Localized swelling, mass and lump, unspecified upper limb
R22.31Localized swelling, mass and lump, right upper limb
R22.32Localized swelling, mass and lump, left upper limb
R22.33Localized swelling, mass and lump, upper limb, bilateral

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

Official

ICD-10-CM does not list Code First sequencing instructions for R22.3 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for R22.3 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for R22.3 in this effective period.

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.

Coder workflow notes

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What This Code Means

R22.3 is the ICD-10-CM diagnosis code for localized swelling, mass and lump, upper limb. R22.3 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).

Header codes like R22.3 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at R22.3's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R22.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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