2027 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 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

R23.4 is a billable ICD-10-CM diagnosis code for changes in skin texture. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) 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
  • 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

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to R23.4: its own notes plus those printed at block R20-R23 and Chapter 18. A note printed at a category, block or chapter applies to every code under it.

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

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

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

  • epidermal thickening NOS (L85.9)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Block R20-R23 Symptoms and signs involving the skin and subcutaneous tissue applies to 26 codes
From Chapter 18 (R00-R99) Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified applies to 774 codes
  • abnormal findings on antenatal screening of mother (O28.-)
  • certain conditions originating in the perinatal period (P04-P96)
  • signs and symptoms classified in the body system chapters
  • signs and symptoms of breast (N63, N64.5)

Notes

General instructions on how these codes are used.

From Chapter 18 (R00-R99) Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified applies to 774 codes
  • This chapter includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded.
  • Signs and symptoms that point rather definitely to a given diagnosis have been assigned to a category in other chapters of the classification. In general, categories in this chapter include the less well-defined conditions and symptoms that, without the necessary study of the case to establish a final diagnosis, point perhaps equally to two or more diseases or to two or more systems of the body. Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. The Alphabetical Index should be consulted to determine which symptoms and signs are to be allocated here and which to other chapters. The residual subcategories, numbered .8, are generally provided for other relevant symptoms that cannot be allocated elsewhere in the classification.
  • The conditions and signs or symptoms included in categories R00-R94 consist of:
  • (a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated;
  • (b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined;
  • (c) provisional diagnosis in a patient who failed to return for further investigation or care;
  • (d) cases referred elsewhere for investigation or treatment before the diagnosis was made;
  • (e) cases in which a more precise diagnosis was not available for any other reason;
  • (f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

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

  • Parakeratosis

    persistence of the nuclei of the keratinocytes into the stratum corneum of the skin. this is a normal state only in the epithelium of true mucous membranes in the mouth and vagina. (dorland, 27th ed)

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 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About R23.4Overview

What is the ICD-10 code for changes in skin texture?

The ICD-10-CM code for changes in skin texture is R23.4 (sometimes written as R234). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

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, 2026 through September 30, 2027.

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 607, 606, with relative weights from 0.8772 to 1.5721 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.

Can R23.4 be reported with L85.9?

Not as a rule. The Excludes1 note on R23.4 lists "epidermal thickening NOS (L85.9)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).