2026 ICD-10-CM Diagnosis Code R23.4Changes in skin texture

ICD-10-CM Codes›R00–R99›R20-R23›R23

ICD-10-CM R23.4
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

R23.4 is a billable ICD-10-CM diagnosis code for changes in skin texture. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 606 through 607. As a symptom code, it should not be used as a principal diagnosis once a related definitive diagnosis has been established. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Skin/Subcutaneous signs and symptoms.

Code Identity

ICD-10-CM Code
R23.4
Billable Status
Yes — Valid for Submission
Code Describes
Changes in skin texture
Short Description
Changes in skin texture
Same as the full description in the CMS dataset.
Parent Code
R23
Other skin changes

Code Classification

ChapterR00–R99Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
SectionR20-R23Symptoms and signs involving the skin and subcutaneous tissue
CategoryR23Other skin changes
This CodeR23.4Changes in skin texture

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Abnormal desquamation of epithelium
  • Abnormal keratinization
  • Changes in skin texture
  • Circumoral rhytides
  • Crow's feet
  • Crust on skin
  • Decreased keratinization
  • Decreased thickness of skin
  • Desquamation of skin following febrile illness
  • Desquamation secondary to acute systemic illness
  • Diffuse palmoplantar keratoderma with painful fissures
  • Epidermal collarette
  • Fatty dimpling of skin
  • Finding of integrity of skin
  • Finding of thickness of skin
  • Fine wrinkles on face
  • Fissure in skin
  • Fissure in skin of bilateral feet
  • Fissure in skin of bilateral hands
  • Increased keratinization
  • Increased thickness of skin
  • Induration of periwound skin
  • Induration of skin
  • Injection site induration
  • Painful fissure of dorsolateral aspect of skin of fingertip
  • Parakeratosis of skin
  • Parakeratosis scutularis
  • Peeling of skin
  • Rhytide of forehead
  • Rhytide of glabellar skin
  • Rough skin
  • Rough skin of hands
  • Scaling of female perineum
  • Scaly scalp
  • Scaly skin
  • Skin dimple
  • Skin eschar
  • Skin peeling disorder
  • Subcutaneous crepitus
  • Texture of skin or mucosa
  • Thick skin
  • Thickening of skin
  • Thin skin
  • Woody induration of skin and subcutis
  • Wrinkled face
  • Wrinkled skin

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Desquamation of skin
  • Induration of skin
  • Scaling of skin

Type 1 Excludes

  • epidermal thickening NOS L85.9

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Change(s) (in) (of)
      • skin
        • texture
    • Crusts
    • Desquamation, skin
    • Fissure, fissured
      • skin
    • Induration, indurated
      • skin
    • Inelasticity, skin
    • Loss(of)
      • elasticity, skin
    • Parakeratosis
    • Scabs
    • Scales
    • Scaling, skin
    • Thickening
      • skin

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR SYM014
Skin/Subcutaneous signs and symptoms
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Skin Eschar

    a crust that covers necrotic tissue in the skin that is caused by a burn or gangrene.

Patient EducationClinical

Skin Conditions

Your skin is your body's largest organ. It covers the entire outside of your body. There are many ways that your skin protects your body and helps keep you healthy. For example, it:

The full article covers:

  • What does your skin do?
  • What problems and conditions can affect your skin?
  • How can I keep my skin healthy?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert R23.4 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
782.8 Changes in skin texture
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About R23.4Overview

Is R23.4 (Other skin changes) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report changes in skin texture on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does R23.4 group to?

When changes in skin texture is the principal diagnosis on an inpatient stay, it groups to MS-DRG 606, 607, with relative weights from 0.9064 to 1.5132 depending on complications. Higher weights mean higher Medicare reimbursement.

Can R23.4 be a principal diagnosis?

Use it with care. This is a symptom code, so once a definitive diagnosis explaining the changes in skin texture is established, that condition takes the principal position instead.

What is the ICD-9 equivalent of R23.4?

Under the General Equivalence Mappings, changes in skin texture converts to ICD-9-CM 782.8 (changes in skin texture). The mapping is a direct match.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.