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

Compare with another codeCheck this code on a claim

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

Tabular directives
1 inclusion term · 5 Excludes1 · 1 Excludes2

Not billable · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Excludes1Never report with this code
  • abnormal findings on diagnostic imaging (R90-R93)
  • edema (R60.-)
  • enlarged lymph nodes (R59.-)
  • localized adiposity (E65)

+1 more in Instructions

Excludes2Not included here; may be reported together
  • symptoms relating to breast (N64.4-N64.5)
IncludesWhat this code covers
  • subcutaneous nodules (localized)(superficial)

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for R22.3 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on R22.3 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • subcutaneous nodules (localized)(superficial)

Source: inherited from R22

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from R22

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from R20-R23

Coder workflow for R22.3

MedCoder structured workflow — derived from this code’s own official record

Before you code R22.3

  1. R22.3 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewR22.30, R22.31, R22.32, R22.33

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. Check whether an established diagnosis that explains this sign or symptom is documented. If one is, review whether the documented diagnosis changes the coding pathway: a symptom that is integral to a confirmed diagnosis is not reported separately, while one not routinely associated with it may be. Signs and symptoms are reported when no definitive diagnosis is established (Guidelines I.B.4, I.B.5, I.B.6, I.C.18.b).

    Guide: Symptom code vs confirmed diagnosis →

  3. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with R22.3. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support one of the more specific codes beneath R22.3?
    Yes → Select that code and continue the checks below on its own page.
    No → R22.3 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewR22.30, R22.31, R22.32, R22.33

  2. Is an established diagnosis that explains this sign or symptom documented?
    Yes → Review whether the documented diagnosis changes the coding pathway: a symptom integral to it is not reported separately.
    No → Continue — the sign or symptom code stands when no definitive diagnosis is established.
  3. Does the documentation support a condition named in R22.3’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewR60, R59, E65, M25.4

Consider R22.3. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Official instructions as workflow

  • Excludes1 — check before selecting R22.3(5 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with R22.3: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareR60, R59, E65, M25.4

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of R22.3(1 note)

    Coding workflow: The conditions named in this note are not included in R22.3. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    See the official tabular notes · Guidelines I.A.12.b

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The sign or symptom is documented, and the same record establishes a diagnosis that routinely includes it.

Coding question: Is R22.3 reported in addition to the diagnosis?

Path: Review the documented diagnosis and whether the classification treats this finding as integral to it.

Reason: Signs and symptoms integral to a confirmed diagnosis are not coded separately; those not routinely associated with it may be reported when present (Guidelines I.B.5, I.B.6, I.C.18.b).

Documentation: Both the condition R22.3 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewR60, R59, E65, M25.4

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Coding context

The comparisons, hierarchy, index entries, guidelines, relationships, risk-adjustment and coverage context a coder commonly needs. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Don’t confuse R22.3 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of R22.3 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • R90— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of abnormal findings on diagnostic imaging moves the case to R90; the two are not reported together unless documented as unrelated.

    Full comparison: R22.3 vs R90 →

  • R93— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of abnormal findings on diagnostic imaging moves the case to R93; the two are not reported together unless documented as unrelated.

    Full comparison: R22.3 vs R93 →

  • R60— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of edema moves the case to R60; the two are not reported together unless documented as unrelated.

    Full comparison: R22.3 vs R60 →

  • R59— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of enlarged lymph nodes moves the case to R59; the two are not reported together unless documented as unrelated.

    Full comparison: R22.3 vs R59 →

  • E65— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of localized adiposity moves the case to E65; the two are not reported together unless documented as unrelated.

    Full comparison: R22.3 vs E65 →

  • M25.4— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of swelling of joint moves the case to M25.4; the two are not reported together unless documented as unrelated.

    Full comparison: R22.3 vs M25.4 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Code Overview

Localized swelling, mass and lump, upper limb is a non-billable ICD-10-CM category code (R22.3). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Related Codes

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Mass”; these codes share that main term but sit in a different category of the Tabular List.

H93.8 — Other specified disorders of ear (ear), N28.89 — Other specified disorders of kidney and ureter (kidney), N63.0 — Unspecified lump in unspecified breast (breast), R16.0 — Hepatomegaly, not elsewhere classified (liver), R16.1 — Splenomegaly, not elsewhere classified (splenic), R19.00 — Intra-abdominal and pelvic swelling, mass and lump, unspecified site (abdominal), R19.01 — Right upper quadrant abdominal swelling, mass and lump (abdominal, right upper quadrant), R19.02 — Left upper quadrant abdominal swelling, mass and lump (abdominal, left upper quadrant), R19.03 — Right lower quadrant abdominal swelling, mass and lump (abdominal, right lower quadrant), R19.04 — Left lower quadrant abdominal swelling, mass and lump (abdominal, left lower quadrant), R19.05 — Periumbilic swelling, mass or lump (abdominal, periumbilic), R19.06 — Epigastric swelling, mass or lump (abdominal, epigastric), R19.07 — Generalized intra-abdominal and pelvic swelling, mass and lump (abdominal, generalized), R19.09 — Other intra-abdominal and pelvic swelling, mass and lump (umbilical), R91.8 — Other nonspecific abnormal finding of lung field (lung)

Contextual Map

Every relationship of R22.3 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

Nearest codes (14)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Deep reference

Published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Common coding questions

MedCoder editorial

Can R22.3 be billed directly?

No. R22.3 (Localized swelling, mass and lump, upper limb) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 20, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "R22.3 — Localized swelling, mass and lump, upper limb." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/r22.3-localized-swelling-mass-and-lump-upper-limb

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Localized swelling, mass and lump, upper limb

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to R22.3 in its code family, with their registry titles.

View all codes in the R22 family