R22.43 ICD-10-CM Code: Localized swelling, mass and lump, lower limb, bilateral
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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)
R22.43
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceLocalized swelling, mass and lump, lower limb, bilateral
Localized swelling, masses, or lumps present on both lower limbs (both legs).
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
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for R22.43 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for R22.43 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for R22.43 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for R22.43 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for R22.43 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for R22.43 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for R22.43 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 R22.43 an HCC code?
No. R22.43 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
R22.43 is the ICD-10-CM diagnosis code for localized swelling, mass and lump, lower limb, bilateral. Localized swelling, masses, or lumps present on both lower limbs (both legs). R22.43 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).
R22.43 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.
This code requires documentation of bilateral lower limb involvement; ensure both legs are affected.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R22.43 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code requires documentation of bilateral lower limb involvement; ensure both legs are affected
- •Do not use this code if swelling is present on only one leg