Other skin changes (R23)
ICD-10 code R23 covers a variety of skin changes that are not specified elsewhere, including cyanosis, pallor, flushing, spontaneous ecchymoses, texture alterations, and other miscellaneous skin findings. These codes help document unusual or diagnostic skin color or texture changes important for clinical evaluation.
The ICD-10 code for cyanosis (R23.0) captures blue or dusky discoloration of the skin often linked to reduced oxygenation, also known by terms like "blue skin" or "central cyanosis." Pallor (R23.1) refers to paleness or decreased skin color and includes synonyms such as "clammy skin" or "pale face," indicating reduced blood flow or anemia. Flushing (R23.2) is the reddening commonly seen with conditions like hot flashes or rosacea. Spontaneous ecchymoses (R23.3) represent spontaneous bruising or skin bleeding without trauma. Changes in skin texture (R23.4) include thickening, wrinkling, scaling, or peeling, describing alterations in skin integrity like "crow’s feet" or "rough skin." The code R23.8 covers other miscellaneous changes such as mottling, delayed healing, or abnormal pigmentation, while R23.9 is used when skin changes are noted but not specified, covering findings like "poor skin condition" or "cutaneous insect bite reaction." These codes aid both healthcare professionals and coders in documenting and billing for diverse skin abnormalities documented in clinical settings.
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.
Blister
Visible accumulations of fluid within or beneath the epidermis.
Cyanosis
A bluish or purplish discoloration of the skin and mucous membranes due to an increase in the amount of deoxygenated hemoglobin in the blood or a structural defect in the hemoglobin molecule.
Flushing
A transient reddening of the face that may be due to fever, certain drugs, exertion, or stress.
Herpes Labialis
Herpes simplex, caused by type 1 virus, primarily spread by oral secretions and usually occurring as a concomitant of fever. It may also develop in the absence of fever or prior illness. It commonly involves the facial region, especially the lips and the nares. (Dorland, 27th ed.)
Livedo Reticularis
A condition characterized by a reticular or fishnet pattern on the skin of lower extremities and other parts of the body. This red and blue pattern is due to deoxygenated blood in unstable dermal blood vessels. The condition is intensified by cold exposure and relieved by rewarming.
Livedoid Vasculopathy
A rare cutaneous thrombotic disease due to occlusion of dermal vessels. It is characterized by purpuric maculae and ulcerations especially during summer which form scars called atrophie blanche. It is more associated with other syndromes (e.g., PROTEIN C DEFICIENCY; HYPERHOMOCYSTEINEMIA). Livedo reticularis with systemic involvement and stroke is SNEDDON SYNDROME.
Orthostatic Intolerance
Symptoms of cerebral hypoperfusion or autonomic overaction which develop while the subject is standing, but are relieved on recumbency. Types of this include NEUROCARDIOGENIC SYNCOPE; POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME; and neurogenic ORTHOSTATIC HYPOTENSION. (From Noseworthy, JH., Neurological Therapeutics Principles and Practice, 2007, p2575-2576)
Pallor
A clinical manifestation consisting of an unnatural paleness of the skin.
Piloerection
Involuntary erection or bristling of hairs.
POEMS Syndrome
A multisystemic disorder characterized by a sensorimotor polyneuropathy (POLYNEUROPATHIES), organomegaly, endocrinopathy, monoclonal gammopathy, and pigmentary skin changes. Other clinical features which may be present include EDEMA; CACHEXIA; microangiopathic glomerulopathy; pulmonary hypertension (HYPERTENSION, PULMONARY); cutaneous necrosis; THROMBOCYTOSIS; and POLYCYTHEMIA. This disorder is frequently associated with osteosclerotic myeloma. (From Adams et al., Principles of Neurology, 6th ed, p1335; Rev Med Interne 1997;18(7):553-62)
Postural Orthostatic Tachycardia Syndrome
A syndrome of ORTHOSTATIC INTOLERANCE combined with excessive upright TACHYCARDIA, and usually without associated ORTHOSTATIC HYPOTENSION. All variants have in common an excessively reduced venous return to the heart (central HYPOVOLEMIA) while upright.
Skin Pigmentation
Coloration of the skin.
Sneddon Syndrome
A systemic non-inflammatory arteriopathy primarily of middle-aged females characterized by the association of LIVEDO RETICULARIS, multiple thrombotic CEREBRAL INFARCTION; CORONARY DISEASE, and HYPERTENSION. Elevation of antiphospholipid antibody titers (see also ANTIPHOSPHOLIPID SYNDROME), cardiac valvulopathy, ISCHEMIC ATTACK, TRANSIENT; SEIZURES; DEMENTIA; and chronic ischemia of the extremities may also occur. Pathologic examination of affected arteries reveals non-inflammatory adventitial fibrosis, thrombosis, and changes in the media (From Jablonski, Dictionary of Syndromes & Eponymic Diseases, 2d ed; Adams et al., Principles of Neurology, 6th ed, p861; Arch Neurol 1997 Jan;54(1):53-60). Mutations in the CECR1 gene (ADA2 protein, human) are associated with Sneddon syndrome.
