Disturbances of skin sensation (R20)
The ICD-10 code section R20 covers a range of disturbances of skin sensation, including anesthesia, hypoesthesia, paresthesia, hyperesthesia, and other sensory abnormalities. These codes help healthcare professionals specify types of altered skin sensations, such as numbness, tingling, or increased sensitivity.
This group of codes details unique sensory conditions affecting the skin. For example, R20.0 is used for anesthesia of skin, describing complete loss of sensation often referred to as numbness in areas like the face, limbs, or specific regions (e.g., “stocking anesthesia”). R20.1 captures hypoesthesia, meaning reduced skin sensation, sometimes linked to surgical complications or congenital conditions. R20.2 identifies paresthesia, which includes tingling or pins-and-needles sensations commonly called “numbness and tingling.” Meanwhile, R20.3 represents hyperesthesia, describing increased or abnormal sensitivity, including painful responses to normally non-painful stimuli (allodynia). Codes R20.8 and R20.9 cover other or unspecified skin sensation disturbances, addressing diverse or unclear symptoms. Medical coders use these codes to accurately document and differentiate sensory skin issues encountered in clinical settings, ensuring proper classification and communication.
Instructional Notations
Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
Clinical Terms
The following clinical terms provide additional context, helping users better understand the clinical background and common associations for each diagnosis listed in this section. Including related terms alongside ICD-10-CM codes supports coders, billers, and healthcare professionals in improving accuracy, enhancing documentation, and facilitating research or patient education.
Hyperacusis
An abnormally disproportionate increase in the sensation of loudness in response to auditory stimuli of normal volume. COCHLEAR DISEASES; VESTIBULOCOCHLEAR NERVE DISEASES; FACIAL NERVE DISEASES; STAPES SURGERY; and other disorders may be associated with this condition.
Hyperalgesia
An increased sensation of pain or discomfort produced by minimally noxious stimuli due to damage to soft tissue containing NOCICEPTORS or injury to a peripheral nerve.
Hyperesthesia
Increased sensitivity to cutaneous stimulation due to a diminished threshold or an increased response to stimuli.
Nociceptors
Peripheral AFFERENT NEURONS which are sensitive to injuries or pain, usually caused by extreme thermal exposures, mechanical forces, or other noxious stimuli. Their cell bodies reside in the DORSAL ROOT GANGLIA. Their peripheral terminals (NERVE ENDINGS) innervate target tissues and transduce noxious stimuli via axons to the CENTRAL NERVOUS SYSTEM.
Paresthesia
Subjective cutaneous sensations (e.g., cold, warmth, tingling, pressure, etc.) that are experienced spontaneously in the absence of stimulation.
Synesthesia
The experience of involuntary sensory cross activation where the presentation of a particular stimulus elicits a secondary sensory-perceptual experience. It most commonly occurs in the association of color with linguistic stimuli such as letters, numbers, words, or music, but can also occur between other senses. Although synesthesia can be acquired or transient due to trauma or drug use, there is also a strong genetic component, with a prevalence of about 1 in 2,000 individuals and a female to male ratio of 6:1.
