R23.2 ICD-10-CM Code: Flushing

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for R23.2 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on R23.2 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for R23.2

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

Before you code R23.2

1. 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 →

Choose the right path

1. 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.
2. Is the underlying (etiologic) condition the Code First note names documented?
   Yes → Sequence the underlying condition first, then R23.2.
   No → Continue; do not add an underlying condition the record does not document.

   ReviewN95.1

Consider R23.2. 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).

The underlying (etiologic) condition

Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).

Official instructions as workflow

• Excludes2 — not part of R23.2(1 note)

  Coding workflow: The conditions named in this note are not included in R23.2. 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

• Code First — sequencing check(1 note)

  Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before R23.2. Do not add an underlying condition the record does not document.

  ReviewN95.1

  See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

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

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.

Indexed Clinical Terms (4)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Blushing (abnormal) (excessive)
• Change (s) (in) (of), skin, flushing
• Flushing
• Plethora

Don’t confuse R23.2 with…

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

The codes most likely to be picked instead of R23.2 — 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.

• R23.9— Specificity relationship (Review)

  Overlapping diagnoses in the same category.

  Overlapping codes in the same category — the documentation decides which is the more specific fit.

  What moves you there: A record that documents no more than “Unspecified skin changes” takes R23.9; specificity in the record moves it back here.

  Full comparison: R23.2 vs R23.9 →

• N64.4— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of symptoms relating to breast adds N64.4; it is not part of this code and both may be reported when both are documented.

  Full comparison: R23.2 vs N64.4 →

• N64.5— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of symptoms relating to breast adds N64.5; it is not part of this code and both may be reported when both are documented.

  Full comparison: R23.2 vs N64.5 →

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.

Verify Before Coding

• No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 2 MS-DRGs: DRG 947 (MDC 23), DRG 948 (MDC 23).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):SYM014 — Skin/Subcutaneous signs and symptoms (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Skin/Subcutaneous signs and symptoms).

R20.9 — Unspecified disturbances of skin sensation, R21 — Rash and other nonspecific skin eruption, R22.0 — Localized swelling, mass and lump, head, R22.1 — Localized swelling, mass and lump, neck, R22.2 — Localized swelling, mass and lump, trunk, R22.30 — Localized swelling, mass and lump, unspecified upper limb, R22.31 — Localized swelling, mass and lump, right upper limb, R22.32 — Localized swelling, mass and lump, left upper limb, R22.33 — Localized swelling, mass and lump, upper limb, bilateral, R22.40 — Localized swelling, mass and lump, unspecified lower limb, R22.41 — Localized swelling, mass and lump, right lower limb, R22.42 — Localized swelling, mass and lump, left lower limb, R22.43 — Localized swelling, mass and lump, lower limb, bilateral, R22.9 — Localized swelling, mass and lump, unspecified, R23.0 — Cyanosis, R23.1 — Pallor, R23.3 — Spontaneous ecchymoses, R23.4 — Changes in skin texture, R23.8 — Other skin changes, R23.9 — Unspecified skin changes, +5 more

Same Index main term, other category

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

L56.9 — Acute skin change due to ultraviolet radiation, unspecified (skin, acute, due to ultraviolet radiation), L57.8 — Other skin changes due to chronic exposure to nonionizing radiation (skin, chronic, due to nonionizing radiation, specified NEC), L57.9 — Skin changes due to chronic exposure to nonionizing radiation, unspecified (skin, chronic, due to nonionizing radiation), M46.1 — Sacroiliitis, not elsewhere classified (inflammatory, sacroiliac), M53.3 — Sacrococcygeal disorders, not elsewhere classified (sacroiliac joint), N05.0 — Unspecified nephritic syndrome with minor glomerular abnormality (minimal), N95.1 — Menopausal and female climacteric states (menopausal), P61.1 — Polycythemia neonatorum (newborn), R19.4 — Change in bowel habit (bowel habit), R20.8 — Other disturbances of skin sensation (sensory), R41.82 — Altered mental status, unspecified (mental status), R41.89 — Other symptoms and signs involving cognitive functions and awareness (cognitive), R49.8 — Other voice and resonance disorders (voice, specified NEC), R49.9 — Unspecified voice and resonance disorder (voice), R54 — Age-related physical debility (senile), Z30.433 — Encounter for removal and reinsertion of intrauterine contraceptive device (contraceptive device), Z45.010 — Encounter for checking and testing of cardiac pacemaker pulse generator [battery] (pacemaker, pulse generator), Z45.018 — Encounter for adjustment and management of other part of cardiac pacemaker (pacemaker), Z46.6 — Encounter for fitting and adjustment of urinary device (indwelling catheter), Z48.00 — Encounter for change or removal of nonsurgical wound dressing (dressing), +22 more

Contextual Map

Every relationship of R23.2 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.

Run R23.2 with this related code in Claim Check

Hierarchy

• R00-R99 — Chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99) (R00-R99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R20-R23 — Symptoms and signs involving the skin and subcutaneous tissue[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Code First

• N95.1 — Menopausal and female climacteric states[Code First]: “, if applicable, menopausal and female climacteric states (N95.1)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• SYM014 — Skin/Subcutaneous signs and symptoms[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

MS-DRG Grouper

• DRG 947 — SIGNS AND SYMPTOMS WITH MCC[MS-DRG]: “SIGNS AND SYMPTOMS WITH MCC (MDC 23)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 948 — SIGNS AND SYMPTOMS WITHOUT MCC[MS-DRG]: “SIGNS AND SYMPTOMS WITHOUT MCC (MDC 23)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

• MDC 23 — Factors Influencing Health Status and Other Contacts with Health Services[MDC crossing]: “Factors Influencing Health Status and Other Contacts with Health Services — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,235 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

• Blushing (abnormal) (excessive)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Change (s) (in) (of), skin, flushing[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Flushing[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Plethora[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes

• R23 — Other skin changes[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R23.0 — Cyanosis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R23.1 — Pallor[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R23.3 — Spontaneous ecchymoses[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R23.4 — Changes in skin texture[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R23.8 — Other skin changes[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R23.9 — Unspecified skin changes[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Change history

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

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 FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Inpatient payment groups Official source data

CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 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 structured 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 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.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to R23.2 in its code family, with their registry titles.

• R23 — Other skin changes
• R23.0 — Cyanosis
• R23.1 — Pallor
• R23.3 — Spontaneous ecchymoses
• R23.4 — Changes in skin texture
• R23.8 — Other skin changes
• R23.9 — Unspecified skin changes

View all codes in the R23 family