Earn up to 50 CME hours through OMED 2025 On-Demand content, available through Dec. 31, 2025 | REGISTER NOW

Practicing Medicine Business of Medicine ICD-10 & ICD-11 Updates

ICD-10 & ICD-11 Updates

Code reset

Summary of 2026 ICD-10 changes and ICD-11 news

Ensure your practice is prepared to navigate annual updates

Ensure your practice is up to date with the latest changes to the ICD-10-CM coding and reporting guidelines, which take effect annually on Oct. 1. These codes are maintained by the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) under the authorization of the World Health Organization (WHO) and were developed for use by the Centers for Medicare & Medicaid Services (CMS).

The AOA provides resources to help osteopathic physicians navigate updates to the ICD-10 code set, a comprehensive classification system for diagnoses, symptoms, abnormal findings, and external causes of injury or disease.

View the AOA’s on-demand webinar for expert insights on recent ICD-10 revisions.

Members-only content

This content is offered as a benefit of AOA membership. If you're an AOA member, log in to receive full access to member-exclusive articles, dashboards and resources.

Log in to view

Update on ICD-11

In 2022, the World Health Organization (WHO) formally transitioned to the International Classification of Diseases, 11th Revision (ICD-11) code set, from ICD-10. The code set is now available for WHO member countries to adopt for recording and reporting health-related conditions. Use of standardized nomenclatures, such as ICD in diagnosis reporting is essential to healthcare operations, billing and payment and public health surveillance.

Since the first half of 2023, the AOA has been actively engaging with the National Committee on Vital Health Statistics (NCVHS) within the U.S. Department of Health and Human Services (HHS) to follow the committee’s evaluation of ICD-11 and development of recommendations regarding adoption and implementation of the code set in the U.S.

Overview of ICD-11 structure

ICD-11 as a code set is fundamentally different in structure from the ICD-10-CM code set. The code set uses a foundation, or system of base codes that can be rolled up into different categories, and then a system of extension codes to create granularity. Through this system of stem and extension combinations, a coding framework that accounts for more specific diagnoses and conditions that account for over 90% of the ICD-10-CM code set can be developed.1,2 For example, ICD-11 contains a single stem code for an arm fracture which can be paired with extension codes to describe where the fracture occurred.

A recent analysis of the adequacy of ICD-11 for morbidity coding was conducted by researchers at the National Library of Medicine. Researchers performed one horizontal sample of the most commonly used ICD-10 codes and one vertical sample across the digestive diseases section of the ICD-10-CM. Key findings from this analysis were that:

  • Overall, ICD-11 provides much more descriptive detail than ICD-10
  • Over 90% of current ICD-10-CM codes can be mapped to ICD-11 following mapping processes referred to as “post coordination” and “linearization”
  • Gaps in the code set are dispersed and not specific to any condition areas

Key considerations for somatic dysfunction

The ICD-11 code set generally provides sufficient granularity to map ICD-10 to ICD-11. Further, it may allow coding for somatic dysfunction with greater detail than is currently possible. Similar to the arm fracture example noted above, this would be achieved by using the somatic dysfunction base code with extension codes for surface topography.

However, there are more than 10 surface topography extension codes (compared to the 10 body regions specified in current ICD-10 somatic dysfunction codes). Thus, when being implemented in the U.S., policymakers must define what combinations of stem and extension codes are appropriate. AOA must be closely engaged in the post-coordination process.

Adoption of the ICD-11 code set in the U.S. and timeline uncertainty

The process of adopting and implementing ICD-11 is highly dependent on U.S. engagement with WHO. The WHO must support any post-coordination efforts countries wish to implement and must also grant states permission if they wish to engage in clinical modification.3 Additionally, unlike ICD-10, the ICD-11 code set is designed to be updated regularly, and WHO has established a process for doing so where stakeholders can request new codes or modifications. Ultimately, the post-coordination process in the U.S. will require working with WHO to define the appropriate extensions.

Based on historical precedent, there are several critical steps that typically must be taken in order for ICD-11 to be adopted and implemented in the U.S.:

  • The National Committee on Vital Health Statistics must make a recommendation to the HHS Secretary regarding the adoption of ICD-11 and the agency that should be responsible for the process, including liaising with WHO.
  • A liaison to WHO must be appointed.
  • A mapping of ICD-11 to ICD-10-CM across the code set must be completed.
  • WHO must approve any modifications if the code set is not implemented in its entirety.
  • HHS must issue a notice of proposed rulemaking and seek public comment on adoption.

This multi-year process has not yet been initiated. Additionally, recent actions by the Trump administration, including a restructuring of the Department of Health and Human Services, as well as threats to withdraw from the World Health Organization, have created uncertainty regarding the timeline and process for a potential transition. The AOA is monitoring developments closely and will keep members updated as information becomes available.

References

  1. Fung KW, Xu J, McConnell-Lamptey S, Pickett D, Bodenreider O. A practical strategy to use the ICD-11 for morbidity coding in the United States without a clinical modification. J Am Med Inform Assoc. 2023 Sep 25;30(10):1614-1621. doi: 10.1093/jamia/ocad128. PMID: 37407272; PMCID: PMC10531107.
  2. Mabon, K., Steinum, O. & Chute, C.G. Postcoordination of codes in ICD-11. BMC Med Inform Decis Mak 21 (Suppl 6), 379 (2021). https://doi.org/10.1186/s12911-022-01876-9.
  3. https://cdn.who.int/media/docs/default-source/classification/icd/icd11/icd11-license.pdf?sfvrsn=45de958_7&download=true

ICD-10 changes for 2026

CMS has released the latest updates to the ICD-10-CM code set, effective for services provided from Oct. 1, 2025 through Sept. 30, 2026. This year’s update includes: 487 new codes, 38 revised codes and 28 deleted codes.

The full list of changes can be found on the CMS ICD-10 webpage.

Notable new codes & revisions

  • 213 new injury/poisoning codes, with greater specification for contusions, abrasions, puncture wounds, lacerations, bites, including laterality and depth
  • 116 new chronic ulcer codes with staging and necrosis detail across multiple body parts
  • More than one dozen codes for xylazine-related toxic skin injuries, mapping both toxin and wound site
  • New thyroid eye disease/orbitopathy codes (left, right, bilateral) and refined eyelid inflammation codes
  • A code for Type 2 diabetes in remission
  • New hematologic deficiency codes, including neutrophil disorders
  • Expanded congenital/syndromic malformation codes
  • Location-specific pain codes replacing generic ones
  • New blast injury codes for war/military exposures, capturing overpressure effects
  • New codes for Demodex mite and other acariasis infestations
  • Additional Z-codes and external cause codes for social/contextual factors

Details by chapter

Select an option below to view additional information regarding code changes

Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99)

Number of deleted codes: 1

  • B88.0 Other acariasis (Demodex)

Number of revisions: 0
Number of new codes: 2

  • B88.01 Infestation by Demodex mites
  • B88.09 Other acariasis (other specified acariasis)
Chapter 2: Neoplasms (C00-D49)

Number of deleted codes: 0
Number of revisions: 0
Number of new codes: 3

  • C50.A0 Malignant inflammatory neoplasm of unspecified breast
  • C50.A1 Malignant inflammatory neoplasm of right breast
  • C50.A2 Malignant inflammatory neoplasm of left breast
Chapter 3: Diseases of the Blood and Blood-Forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89)

Number of deleted codes: 1

  • D71 Functional disorders of polymorphonuclear neutrophils

Number of revisions: 0
Number of new codes: 3

  • D71.1 Leukocyte adhesion deficiency
  • D71.8 Other functional disorders of polymorphonuclear neutrophil
  • D71.9 Functional disorders of polymorphonuclear neutrophils, unspecified
Chapter 4: Endocrine, Nutritional and Metabolic Diseases (E00-E89)

Number of deleted codes: 3

  • E72.53 Primary hyperoxaluria
  • E78.01 Familial hypercholesterolemia
  • E88.1 Lipodystrophy, not elsewhere classified

Number of revisions: 0
Number of new codes: 23

  • E11.A Type 2 diabetes mellitus without complications in remission
  • E72.530 Primary hyperoxaluria, type 1
  • E72.538 Other specified primary hyperoxaluria
  • E72.539 Primary hyperoxaluria, unspecified
  • E72.540 Dietary hyperoxaluria
  • E72.541 Enteric hyperoxaluria
  • E72.548 Other secondary hyperoxaluria
  • E72.549 Secondary hyperoxaluria, unspecified
  • E78.010 Homozygous familial hypercholesterolemia [HoFH]
  • E78.011 Heterozygous familial hypercholesterolemia [HeFH]
  • E78.019 Familial hypercholesterolemia, unspecified
  • E83.820 Generalized arterial calcification of infancy with unspecified genetic causality
  • E83.821 ENPP1 deficiency causing generalized arterial calcification of infancy
  • E83.822 ENPP1 deficiency causing autosomal recessive hypophosphatemic rickets type 2
  • E83.823 ABCC6 deficiency causing generalized arterial calcification of infancy
  • E83.824 ABCC6 deficiency causing pseudoxanthoma elasticum
  • E83.825 CD73 deficiency causing arterial calcification
  • E88.10 Lipodystrophy, unspecified
  • E88.11 Partial lipodystrophy
  • E88.12 Generalized lipodystrophy
  • E88.13 Localized lipodystrophy
  • E88.14 HIV-associated lipodystrophy
  • E88.19 Other lipodystrophy, not elsewhere classified
Chapter 5: Mental, Behavioral and Neurodevelopmental Disorders (F01-F99)

Number of deleted codes: 0
Number of revisions: 0
Number of new codes: 0

Chapter 6: Diseases of the Nervous System (G00-G99)

Number of deleted codes: 1

  • G35 Multiple sclerosis

Number of revisions: 0
Number of new codes: 10

  • G31.87 Primary progressive apraxia of speech
  • G35.A Relapsing-remitting multiple sclerosis
  • G35.B0 Primary progressive multiple sclerosis, unspecified
  • G35.B1 Active primary progressive multiple sclerosis
  • G35.B2 Non-active primary progressive multiple sclerosis
  • G35.C0 Secondary progressive multiple sclerosis, unspecified
  • G35.C1 Active secondary progressive multiple sclerosis
  • G35.C2 Non-active secondary progressive multiple sclerosis
  • G35.D Multiple sclerosis, unspecified
  • G71.036 Limb girdle muscular dystrophy due to fukutin related protein dysfunction
Chapter 7: Diseases of the Eye and Adnexa (H00-H59)

Number of deleted codes: 1

  • H01.8 Other specified inflammation of eyelid

Number of revisions: 0
Number of new codes: 17

  • H01.81 Other specified inflammation of right upper eyelid
  • H01.82 Other specified inflammation of right lower eyelid
  • H01.83 Other specified inflammation of right eye, unspecified eyelid
  • H80.84 Other specified inflammation of left upper eyelid
  • H01.85 Other specified inflammation of left lower eyelid
  • H01.86 Other specified inflammation of left eye, unspecified eyelid
  • H01.89 Other specified inflammation of unspecified eye, unspecified eyelid
  • H01.8A Other specified inflammation of right eye, upper and lower eyelids
  • H01.8B Other specified inflammation of left eye, upper and lower eyelids
  • H05.831 Thyroid orbitopathy, right orbit
  • H05.832 Thyroid orbitopathy, left orbit
  • H05.833 Thyroid orbitopathy, bilateral
  • H05.839 Thyroid orbitopathy, unspecified orbit
  • H40.841 Neovascular secondary angle closure glaucoma, right eye
  • H40.842 Neovascular secondary angle closure glaucoma, left eye
  • H40.843 Neovascular secondary angle closure glaucoma, bilateral
  • H40.849 Neovascular secondary angle closure glaucoma, unspecified eye
Chapter 8: Diseases of the Ear and Mastoid Process (H60-H95)

Number of deleted codes: 0
Number of revisions: 0
Number of new codes: 0

Chapter 9: Diseases of the Circulatory System (I00-I99)

Number of deleted codes: 0
Number of revisions: 0
Number of new codes: 4

  • I27.840 Fontan-associated liver disease [FALD]
  • I27.841 Fontan-associated lymphatic dysfunction
  • I27.848 Other Fontan-associated condition
  • I27.849 Fontan related circulation, unspecified
Chapter 10: Diseases of the Respiratory System (J00-J99), U07.0

Number of deleted codes: 0
Number of revisions: 0
Number of new codes: 0

Chapter 11: Diseases of the Digestive System (K00-K95)

Number of deleted codes: 0
Number of revisions: 0
Number of new codes: 0

Chapter 12: Diseases of the Skin and Subcutaneous Tissue (L00-L99)

Number of deleted codes: 0
Number of revisions: 2

  • L02.212 Cutaneous abscess of back [any part, except buttock and flank]
  • L02.222 Furuncle of back [any part, except buttock and flank]

Number of new codes: 116

  • L02.217 Cutaneous abscess of flank
  • L02.227 Furuncle of flank
  • L03.31A Cellulitis of flank
  • L03.32A Acute lymphangitis of flank
  • L98.431 Non-pressure chronic ulcer of abdomen limited to breakdown of skin
  • L98.432 Non-pressure chronic ulcer of abdomen with fat layer exposed
  • L98.433 Non-pressure chronic ulcer of abdomen with necrosis of muscle
  • L98.434 Non-pressure chronic ulcer of abdomen with necrosis of bone
  • L98.435 Non-pressure chronic ulcer of abdomen with muscle involvement without evidence of necrosis
  • L98.436 Non-pressure chronic ulcer of abdomen with bone involvement without evidence of necrosis
  • L98.438 Non-pressure chronic ulcer of abdomen with other specified severity
  • L98.439 Non-pressure chronic ulcer of abdomen with unspecified severity
  • L98.441 Non-pressure chronic ulcer of chest limited to breakdown of skin
  • L98.442 Non-pressure chronic ulcer of chest with fat layer exposed
  • L98.443 Non-pressure chronic ulcer of chest with necrosis of muscle
  • L98.444 Non-pressure chronic ulcer of chest with necrosis of bone
  • L98.445 Non-pressure chronic ulcer of chest with muscle involvement without evidence of necrosis
  • L98.446 Non-pressure chronic ulcer of chest with bone involvement without evidence of necrosis
  • L98.448 Non-pressure chronic ulcer of chest with other specified severity
  • L98.449 Non-pressure chronic ulcer of chest with unspecified severity
  • L98.451 Non-pressure chronic ulcer of neck limited to breakdown of skin
  • L98.452 Non-pressure chronic ulcer of neck with fat layer exposed
  • L98.453 Non-pressure chronic ulcer of neck with necrosis of muscle
  • L98.454 Non-pressure chronic ulcer of neck with necrosis of bone
  • L98.455 Non-pressure chronic ulcer of neck with muscle involvement without evidence of necrosis
  • L98.456 Non-pressure chronic ulcer of neck with bone involvement without evidence of necrosis
  • L98.458 Non-pressure chronic ulcer of neck with other specified severity
  • L98.459 Non-pressure chronic ulcer of neck with unspecified severity
  • L98.461 Non-pressure chronic ulcer of face limited to breakdown of skin
  • L98.462 Non-pressure chronic ulcer of face with fat layer exposed
  • L98.463 Non-pressure chronic ulcer of face with necrosis of muscle
  • L98.464 Non-pressure chronic ulcer of face with necrosis of bone
  • L98.465 Non-pressure chronic ulcer of face with muscle involvement without evidence of necrosis
  • L98.466 Non-pressure chronic ulcer of face with bone involvement without evidence of necrosis
  • L98.468 Non-pressure chronic ulcer of face with other specified severity
  • L98.469 Non-pressure chronic ulcer of face with unspecified severity
  • L98.471 Non-pressure chronic ulcer of groin limited to breakdown of skin
  • L98.472 Non-pressure chronic ulcer of groin with fat layer exposed
  • L98.473 Non-pressure chronic ulcer of groin with necrosis of muscle
  • L98.474 Non-pressure chronic ulcer of groin with necrosis of bone
  • L98.475 Non-pressure chronic ulcer of groin with muscle involvement without evidence of necrosis
  • L98.476 Non-pressure chronic ulcer of groin with bone involvement without evidence of necrosis
  • L98.478 Non-pressure chronic ulcer of groin with other specified severity
  • L98.479 Non-pressure chronic ulcer of groin with unspecified severity
  • L98.A111 Non-pressure chronic ulcer of right upper arm limited to breakdown of skin
  • L98.A112 Non-pressure chronic ulcer of right upper arm with fat layer exposed
  • L98.A113 Non-pressure chronic ulcer of right upper arm with necrosis of muscle
  • L98.A114 Non-pressure chronic ulcer of right upper arm with necrosis of bone
  • L98.A115 Non-pressure chronic ulcer of right upper arm with muscle involvement without evidence of necrosis
  • L98.A116 Non-pressure chronic ulcer of right upper arm with bone involvement without evidence of necrosis
  • L98.A118 Non-pressure chronic ulcer of right upper arm with other specified severity
  • L98.A119 Non-pressure chronic ulcer of right upper arm with unspecified severity
  • L98.A121 Non-pressure chronic ulcer of left upper arm limited to breakdown of skin
  • L98.A122 Non-pressure chronic ulcer of left upper arm with fat layer exposed
  • L98.A123 Non-pressure chronic ulcer of left upper arm with necrosis of muscle
  • L98.A124 Non-pressure chronic ulcer of left upper arm with necrosis of bone
  • L98.A125 Non-pressure chronic ulcer of left upper arm with muscle involvement without evidence of necrosis
  • L98.A126 Non-pressure chronic ulcer of left upper arm with bone involvement without evidence of necrosis
  • L98.A128 Non-pressure chronic ulcer of left upper arm with other specified severity
  • L98.A129 Non-pressure chronic ulcer of left upper arm with unspecified severity
  • L98.A191 Non-pressure chronic ulcer of unspecified upper arm limited to breakdown of skin
  • L98.A192 Non-pressure chronic ulcer of unspecified upper arm with fat layer exposed
  • L98.A193 Non-pressure chronic ulcer of unspecified upper arm with necrosis of muscle
  • L98.A194 Non-pressure chronic ulcer of unspecified upper arm with necrosis of bone
  • L98.A195 Non-pressure chronic ulcer of unspecified upper arm with muscle involvement without evidence of necrosis
  • L98.A196 Non-pressure chronic ulcer of unspecified upper arm with bone involvement without evidence of necrosis
  • L98.A198 Non-pressure chronic ulcer of unspecified upper arm with other specified severity
  • L98.A199 Non-pressure chronic ulcer of unspecified upper arm with unspecified severity
  • L98.A211 Non-pressure chronic ulcer of right forearm limited to breakdown of skin
  • L98.A212 Non-pressure chronic ulcer of right forearm with fat layer exposed
  • L98.A213 Non-pressure chronic ulcer of right forearm with necrosis of muscle
  • L98.A214 Non-pressure chronic ulcer of right forearm with necrosis of bone
  • L98.A215 Non-pressure chronic ulcer of right forearm with muscle involvement without evidence of necrosis
  • L98.A216 Non-pressure chronic ulcer of right forearm with bone involvement without evidence of necrosis
  • L98.A218 Non-pressure chronic ulcer of right forearm with other specified severity
  • L98.A219 Non-pressure chronic ulcer of right forearm with unspecified severity
  • L98.A221 Non-pressure chronic ulcer of left forearm limited to breakdown of skin
  • L98.A222 Non-pressure chronic ulcer of left forearm with fat layer exposed
  • L98.A223 Non-pressure chronic ulcer of left forearm with necrosis of muscle
  • L98.A224 Non-pressure chronic ulcer of left forearm with necrosis of bone
  • L98.A225 Non-pressure chronic ulcer of left forearm with muscle involvement without evidence of necrosis
  • L98.A226 Non-pressure chronic ulcer of left forearm with bone involvement without evidence of necrosis
  • L98.A228 Non-pressure chronic ulcer of left forearm with other specified severity
  • L98.A229 Non-pressure chronic ulcer of left forearm with unspecified severity
  • L98.A291 Non-pressure chronic ulcer of unspecified forearm limited to breakdown of skin
  • L98.A292 Non-pressure chronic ulcer of unspecified forearm with fat layer exposed
  • L98.A293 Non-pressure chronic ulcer of unspecified forearm with necrosis of muscle
  • L98.A294 Non-pressure chronic ulcer of unspecified forearm with necrosis of bone
  • L98.A295 Non-pressure chronic ulcer of unspecified forearm with muscle involvement without evidence of necrosis
  • L98.A296 Non-pressure chronic ulcer of unspecified forearm with bone involvement without evidence of necrosis
  • L98.A298 Non-pressure chronic ulcer of unspecified forearm with other specified severity
  • L98.A299 Non-pressure chronic ulcer of unspecified forearm with unspecified severity
  • L98.A311 Non-pressure chronic ulcer of right hand limited to breakdown of skin
  • L98.A312 Non-pressure chronic ulcer of right hand with fat layer exposed
  • L98.A313 Non-pressure chronic ulcer of right hand with necrosis of muscle
  • L98.A314 Non-pressure chronic ulcer of right hand with necrosis of bone
  • L98.A315 Non-pressure chronic ulcer of right hand with muscle involvement without evidence of necrosis
  • L98.A316 Non-pressure chronic ulcer of right hand with bone involvement without evidence of necrosis
  • L98.A318 Non-pressure chronic ulcer of right hand with other specified severity
  • L98.A319 Non-pressure chronic ulcer of right hand with unspecified severity
  • L98.A321 Non-pressure chronic ulcer of left hand limited to breakdown of skin
  • L98.A322 Non-pressure chronic ulcer of left hand with fat layer exposed
  • L98.A323 Non-pressure chronic ulcer of left hand with necrosis of muscle
  • L98.A324 Non-pressure chronic ulcer of left hand with necrosis of bone
  • L98.A325 Non-pressure chronic ulcer of left hand with muscle involvement without evidence of necrosis
  • L98.A326 Non-pressure chronic ulcer of left hand with bone involvement without evidence of necrosis
  • L98.A328 on-pressure chronic ulcer of left hand with other specified severity
  • L98.A329 Non-pressure chronic ulcer of left hand with unspecified severity
  • L98.A391 Non-pressure chronic ulcer of unspecified hand limited to breakdown of skin
  • L98.A392 Non-pressure chronic ulcer of unspecified hand with fat layer exposed
  • L98.A393 Non-pressure chronic ulcer of unspecified hand with necrosis of muscle
  • L98.A394 Non-pressure chronic ulcer of unspecified hand with necrosis of bone
  • L98.A395 Non-pressure chronic ulcer of unspecified hand with muscle involvement without evidence of necrosis
  • L98.A396 Non-pressure chronic ulcer of unspecified hand with bone involvement without evidence of necrosis
  • L98.A398 Non-pressure chronic ulcer of unspecified hand with other specified severity
  • L98.A399 Non-pressure chronic ulcer of unspecified hand with unspecified severity
Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)

Number of deleted codes: 0
Number of revisions: 3

  • M211.59 Varus Meformity, not elsewhere classified, unspecified hip
  • M24.076 Loose body in unspecified toe joint(s)
  • M61.129 Myositis ossificans progressiva, unspecified upper arm

Number of new codes: 1

  • M05.A Abnormal rheumatoid factor and anti-citrullinated protein antibody with rheumatoid arthritis
Chapter 14: Diseases of the Genitourinary System (N00-N99)

Number of deleted codes: 0
Number of revisions: 0
Number of new codes: 5

  • N00.B1 Acute nephritic syndrome with idiopathic immune membranoproliferative glomerulonephritis (IC-MPGN)
  • N00.B2 Acute nephritic syndrome with secondary immune complex membranoproliferative glomerulonephritis (IC-MPGN)
  • N04.B1 Nephrotic syndrome with idiopathic immune complex membranoproliferative glomerulonephritis (IC-MPGN)
  • N04.B2 Nephrotic syndrome with secondary immune complex membranoproliferative glomerulonephritis (IC-MPGN)
  • N07.B Hereditary nephropathy, not elsewhere classified with APOL1-mediated kidney disease [AMKD]
Chapter 15: Pregnancy, Childbirth and the Puerperium (O00-O9A)

Number of deleted codes: 0
Number of revisions: 0
Number of new codes: 0

Chapter 16: Certain Conditions Originating in the Perinatal Period (P00-P96)

Number of deleted codes: 0
Number of revisions: 1

  • P09.6 Abnormal findings on neonatal hearing screening

Number of new codes: 0

Chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99)

Number of deleted codes: 2

  • Q89.8 Other specified congenital malformations
  • Q99.8 Other specified chromosome abnormalities

Number of revisions: 6

  • Q75.001 Craniosynostosis, unspecified type, unilateral
  • Q75.002 Craniosynostosis unspecified, bilateral
  • Q75.009 Craniosynostosis, unspecified
  • Q75.021 Coronal craniosynostosis, unilateral
  • Q75.022 Coronal craniosynostosis, bilateral
  • Q75.029 Coronal craniosynostosis, unspecified

Number of new codes: 23

  • Q87.87 Hao-Fountain Syndrome
  • Q87.88 CTNNB1 syndrome
  • Q89.81 Kabuki syndrome
  • Q89.89 Other specified congenital malformations
  • Q99.811 Usher syndrome, type 1
  • Q99.812 Usher syndrome, type 2
  • Q99.813 Usher syndrome, type 3
  • Q99.818 Other Usher syndrome
  • Q99.819 Usher syndrome, unspecified
  • Q99.89 Other specified chromosome abnormalities
  • QA0.0101 SCN2A-related neurodevelopmental disorder
  • QA0.0102 CACNA1A-related neurodevelopmental disorder
  • QA0.0109 Neurodevelopmental disorder related to pathogenic variant in other ion channel gene
  • QA0.011 Neurodevelopmental disorders, related to pathogenic variants in glutamate receptor genes
  • QA0.012 Neurodevelopmental disorders, related to pathogenic variants in other receptor genes
  • QA0.0131 SLC6A1-related disorder
  • QA0.0139 Neurodevelopmental disorder, related to pathogenic variant in other transporter or solute carrier gene
  • QA0.0141 Syntaxin-binding protein 1-related disorder
  • QA0.0142 DLG4-related synaptopathy
  • QA0.0149 Neurodevelopmental disorder, related to pathogenic variant in other synapse related gene
  • QA0.0151 FOXG1 syndrome
  • QA0.0159 Neurodevelopmental disorder, related to other genes associated with transcription and gene expression
  • QA0.8 Other neurodevelopmental disorders related to pathogenic variants in other specific genes
Chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99)

Number of deleted codes: 2

  • R10.2 Pelvic and perineal pain
  • R76.8 Other specified abnormal immunological findings in serum

Number of revisions: 0
Number of new codes: 21

  • R10.20 Pelvic and perineal pain unspecified side
  • R10.21 Pelvic and perineal pain right side
  • R10.22 Pelvic and perineal pain left side
  • R10.23 Pelvic and perineal pain bilateral
  • R10.24 Suprapubic pain
  • R10.85 Abdominal pain of multiple sites
  • R10.8A1 Right flank tenderness
  • R10.8A2 Left flank tenderness
  • R10.8A3 Suprapubic tenderness
  • R10.8A9 Flank tenderness, unspecified
  • R10.A0 Flank pain, unspecified side
  • R10.A1 Flank pain, right side
  • R10.A2 Flank pain, left side
  • R10.A3 Flank pain, bilateral
  • R11.16 Cannabis hyperemesis syndrome
  • R39.851 Costovertebral (angle) tenderness, right side
  • R39.852 Costovertebral (angle) tenderness, left side
  • R39.853 Costovertebral (angle) tenderness, bilateral
  • R39.859 Costovertebral (angle) tenderness, unspecified side
  • R76.81 Abnormal rheumatoid factor and anti-citrullinated protein antibody without rheumatoid arthritis
  • R76.89 Other specified abnormal immunological findings in serum
Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)

Number of deleted codes: 12 (these include a seventh character extension that further classifies cases into initial encounters, frequent/recurrent encounters and encounters for long-term sequelae management)

  • S30.1XX Contusion of abdominal wall (3)
  • T78.07X Anaphylactic reaction due to milk and dairy products (3)
  • T78.08X Anaphylactic reaction due to eggs (3)
  • T78.1XX Other adverse food reactions, not elsewhere classified (3)

Number of revisions: 24

  • S62.90XA Unspecified fracture of unspecified hand, initial encounter for closed fracture
  • S62.90XB Unspecified fracture of unspecified hand, initial encounter for open fracture
  • S62.90XD Unspecified fracture of unspecified hand, subsequent encounter for fracture with routine healing
  • S62.90XG Unspecified fracture of unspecified hand, subsequent encounter for fracture with delayed healing
  • S62.90XK Unspecified fracture of unspecified hand, subsequent encounter for fracture with nonunion
  • S62.90XP Unspecified fracture of unspecified hand, subsequent encounter for fracture with malunion
  • S62.90XS Unspecified fracture of unspecified hand, sequela
  • S62.91XA Unspecified fracture of right hand, initial encounter for closed fracture
  • S62.91XB Unspecified fracture of right hand, initial encounter for open fracture
  • S62.91XD Unspecified fracture of right hand, subsequent encounter for fracture with routine healing
  • S62.91XG Unspecified fracture of right hand, subsequent encounter for fracture with delayed healing
  • S62.91XK Unspecified fracture of right hand, subsequent encounter for fracture with nonunion
  • S62.91XP Unspecified fracture of right hand, subsequent encounter for fracture with malunion
  • S62.91XS Unspecified fracture of right hand, sequela
  • S62.92XA Unspecified fracture of left hand, initial encounter for closed fracture
  • S62.92XB Unspecified fracture of left hand, initial encounter for open fracture
  • S62.92XD Unspecified fracture of left hand, subsequent encounter for fracture with routine healing
  • S62.92XG Unspecified fracture of left hand, subsequent encounter for fracture with delayed healing
  • S62.92XK Unspecified fracture of left hand, subsequent encounter for fracture with nonunion
  • S62.92XP Unspecified fracture of left hand, subsequent encounter for fracture with malunion
  • S62.92XS Unspecified fracture of left hand, sequela
  • S74.21XA Injury of cutaneous sensory nerve at hip and thigh level, right leg, initial encounter
  • S74.21XD Injury of cutaneous sensory nerve at hip and thigh level, right leg, subsequent encounter
  • S72.421XS Injury of cutaneous sensory nerve at hip and thigh level, right leg, sequela

Number of new codes: 213 (these include a seventh character extension that further classifies cases into initial encounters, frequent/recurrent encounters and encounters for long-term sequelae management)

  • 11X Contusion of abdominal wall (3)
  • 12X Contusion of groin (3)
  • 13X Contusion of flank (latus) region (3)
  • 81A Abrasion of flank (3)
  • 82A Blister (nonthermal) of flank (3)
  • 84A External constriction of flank (3)
  • 85A Superficial foreign body of flank (3)
  • 86A Insect bite (nonvenomous) of flank (3)
  • 87A Other superficial bite of flank (3)
  • 9AX Unspecified superficial injury of flank (3)
  • 106 Unspecified open wound of abdominal wall, right flank without penetration into peritoneal cavity (3)
  • 107 Unspecified open wound of abdominal wall, left flank without penetration into peritoneal cavity (3)
  • 10A Unspecified open wound of abdominal wall, unspecified flank without penetration into peritoneal cavity (3)
  • 116 Laceration without foreign body of abdominal wall, right flank without penetration into peritoneal cavity (3)
  • 117 Laceration without foreign body of abdominal wall, left flank without penetration into peritoneal cavity (3)
  • 11A Laceration without foreign body of abdominal wall, unspecified flank without penetration into peritoneal cavity (3)
  • 126 Laceration with foreign body of abdominal wall, right flank without penetration into peritoneal cavity (3)
  • 127 Laceration with foreign body of abdominal wall, left flank without penetration into peritoneal cavity (3)
  • 12A Laceration with foreign body of abdominal wall unspecified flank without penetration into peritoneal cavity (3)
  • 136 Puncture wound of abdominal wall without foreign body, right flank without penetration into peritoneal cavity (3)
  • 137 Puncture wound of abdominal wall without foreign body, left flank without penetration into peritoneal cavity (3)
  • 13A Puncture wound of abdominal wall without foreign body, unspecified flank without penetration into peritoneal cavity (3)
  • 146 Puncture wound of abdominal wall with foreign body, right flank without penetration into peritoneal cavity (3)
  • 147 Puncture wound of abdominal wall with foreign body, left flank without penetration into peritoneal cavity (3)
  • 14A Puncture wound of abdominal wall with foreign body, unspecified flank without penetration into peritoneal cavity (3)
  • 156 Open bite of abdominal wall, right flank without penetration into peritoneal cavity (3)
  • 157 Open bite of abdominal wall, left flank without penetration into peritoneal cavity (3)
  • 15A Open bite of abdominal wall, unspecified flank without penetration into peritoneal cavity (3)
  • 606 Unspecified open wound of abdominal wall, right flank with penetration into peritoneal cavity (3)
  • 607 Unspecified open wound of abdominal wall, left flank with penetration into peritoneal cavity (3)
  • 60A Unspecified open wound of abdominal wall, unspecified flank with penetration into peritoneal cavity (3)
  • 616 Laceration without foreign body of abdominal wall, right flank with penetration into peritoneal cavity (3)
  • 617 Laceration without foreign body of abdominal wall, left flank with penetration into peritoneal cavity (3)
  • 61A Laceration without foreign body of abdominal wall, unspecified flank with penetration into peritoneal cavity (3)
  • 626 Laceration with foreign body of abdominal wall, right flank with penetration into peritoneal cavity (3)
  • 627 Laceration with foreign body of abdominal wall, left flank with penetration into peritoneal cavity (3)
  • 62A Laceration with foreign body of abdominal wall, unspecified flank with penetration into peritoneal cavity (3)
  • 636 Puncture wound of abdominal wall without foreign body, right flank with penetration into peritoneal cavity (3)
  • 637 Puncture wound of abdominal wall without foreign body, left flank with penetration into peritoneal cavity (3)
  • 63A Puncture wound of abdominal wall without foreign body, unspecified flank with penetration into peritoneal cavity (3)
  • 646 Puncture wound of abdominal wall with foreign body, right flank with penetration into peritoneal cavity (3)
  • 647 Puncture wound of abdominal wall with foreign body, left flank with penetration into peritoneal cavity (3)
  • 64A Puncture wound of abdominal wall with foreign body, unspecified flank with penetration into peritoneal cavity (3)
  • 656 Open bite of abdominal wall, right flank with penetration into peritoneal cavity (3)
  • 657 Open bite of abdominal wall, left flank with penetration into peritoneal cavity (3)
  • 65A Open bite of abdominal wall, unspecified flank with penetration into peritoneal cavity (3)
  • AX1 Poisoning by fluoroquinolone antibiotics, accidental (unintentional) (3)
  • AX2 Poisoning by fluoroquinolone antibiotics, intentional self-harm (3)
  • AX3 Poisoning by fluoroquinolone antibiotics, assault (3)
  • AX4 Poisoning by fluoroquinolone antibiotics, undetermined (3)
  • AX5 Adverse effect of fluoroquinolone antibiotics (3)
  • AX6 Underdosing of fluoroquinolone antibiotics (3)
  • 841 Toxic effect of xylazine, accidental (unintentional) (3)
  • 842 Toxic effect of xylazine, intentional self-harm (3)
  • 843 Toxic effect of xylazine, assault (3)
  • 844 Toxic effect of xylazine, undetermined (3)
  • 830 Gulf war illness (3)
  • 838 Effects of other war theater (3)
  • 070 Anaphylactic reaction due to milk and dairy products with tolerance to baked milk (3)
  • 071 Anaphylactic reaction due to milk and dairy products with reactivity to baked milk (3)
  • 079 Anaphylactic reaction due to milk and dairy products, unspecified (3)
  • 080 Anaphylactic reaction due to egg with tolerance to baked egg (3)
  • 081 Anaphylactic reaction due to egg with reactivity to baked egg (3)
  • 089 Anaphylactic reaction due to eggs, unspecified (3)
  • 110 Other adverse food reactions due to milk and dairy products with tolerance to baked milk (3)
  • 111 Other adverse food reaction due to milk and dairy products with reactivity to baked milk (3)
  • 119 Other adverse food reaction due to milk and dairy products with baked milk tolerance/reactivity (3)
  • 120 Other adverse food reaction due to egg with tolerance to baked egg (3)
  • 121 Other adverse food reaction due to egg with reactivity to baked egg (3)
  • 129 Other adverse food reaction due to egg with baked egg tolerance/reactivity, unspecified (3)
  • T78.19X Other adverse food reactions, not elsewhere classified (3)
Chapter 20: External Causes of Morbidity (V00-Y99)

Number of deleted codes: 0
Number of revisions: 1

  • Y07.435 Stepbrother, perpetrator or maltreatment and neglect

Number of new codes: 20

  • W44.H9X Other sharp object entering into or through a natural orifice (3)
  • W45.3XX Fishing hook entering through skin (3)
  • Y36.A1X Low level blast overpressure in war operations (3)
  • Y36.A2X High level blast overpressure in war operations (3)
  • Y37.A1X Low level blast overpressure in military operations (3)
  • Y37.A2X High level blast overpressure in military operations (3)
  • Y93.L1 Activity, splitting wood
  • Y93.L9 Activity, other outdoor activity
Chapter 21: Factors Influencing Health Status and Contact with Health Services (Z00-Z99)

Number of deleted codes: 5

  • Z4.08 Encounter for other prophylactic surgery
  • Z59.86 Financial insecurity
  • Z84.1 Family history of disorders of kidney and ureter
  • Z91.011 Allergy to milk products
  • Z91.012 Allergy to eggs

Number of revisions: 1

  • Z83.718 Family history of other colon polyps

Number of new codes: 26

  • Z15.05 Genetic susceptibility to malignant neoplasm of fallopian tube(s)
  • Z15.060 Genetic susceptibility to colorectal cancer
  • Z15.068 Genetic susceptibility to other malignant neoplasm of digestive system
  • Z15.07 Genetic susceptibility to malignant neoplasm of urinary tract
  • Z1.53 Genetic susceptibility to kidney disease
  • Z40.81 Encounter for prophylactic surgery for removal of ovary(s) for persons without known genetic/familial risk factors
  • Z40.82 Encounter for prophylactic surgery for removal of fallopian tube(s) for persons without known genetic/familial risk factors
  • Z40.89 Encounter for other prophylactic surgery
  • Z59.861 Financial insecurity, difficulty paying for utilities
  • Z59.868 Other specified financial insecurity
  • Z59.869 Financial insecurity, unspecified
  • Z77.31 Contact with and (suspected) exposure to Gulf War theater
  • Z77.39 Contact with and (suspected) exposure to other war theater
  • Z80.44 Family history of malignant neoplasm of fallopian tube(s)
  • Z84.11 Family history of APOL1-mediated kidney disease [AMKD]
  • Z84.19 Family history of other disorders of kidney and ureter
  • Z84.A Family history of exposure to diethylstilbestrol
  • Z85.4A Personal history of malignant neoplasm of fallopian tube(s)
  • Z86.00A Personal history of in-situ neoplasm of the fallopian tube(s)
  • Z91.0010 Allergy to milk products, unspecified
  • Z91.0111 Allergy to milk products with tolerance to baked milk
  • Z91.0112 Allergy to milk products with reactivity to baked milk
  • Z91.0120 Allergy to eggs, unspecified
  • Z91.0121 Allergy to eggs with tolerance to baked egg
  • Z91.0122 Allergy to eggs with reactivity to baked egg
  • Z91.B Personal risk factor of exposure to diethylstilbestrol
Chapter 22: Codes for Special Purposes (U00-U85)

Number of deleted codes: 0
Number of revisions: 0
Number of new codes: 0


Official resources

Next steps

The 2026 ICD-10-CM code changes are now active and must be used for all services delivered between Oct. 1, 2025, and Sept. 30, 2026. The next annual update will take effect on Oct. 1, 2026.

Recommended actions for provider practices

To ensure compliance and minimize disruptions, practices should take the following steps:

  • Review code and guideline changes
    Prioritize reviewing updates to the codes most frequently used in your practice, then expand to others that may affect your documentation or billing.
  • Update documentation practices
    Ensure your clinical documentation supports the specificity required by new codes. Revise templates and workflows as needed.
  • Communicate with physicians and staff
    Alert providers and train all staff involved in coding, billing and documentation. Review changes together and identify any necessary process updates.
  • Verify software compatibility
    Confirm with your EHR and billing software vendors that the 2026 ICD-10-CM updates have been implemented. Test functionality and follow up promptly if updates are missing.
  • Check health plan guidance
    Review payer-specific instructions or coverage changes related to the new codes to avoid claim denials or delays.
  • Stay informed year-round
    ICD-10-CM updates occur annually, with potential mid-year additions. Monitor official sources like CMS and the AOA for ongoing changes.

Frequently asked questions

Who must use ICD-10 codes?

All HIPAA-covered entities (health plans, providers, clearinghouses) are required to use ICD-10-CM for diagnosis coding and ICD-10-PCS for inpatient procedure coding in all electronic health transactions. Plans may also require ICD-10 on paper claims for consistency.

If I don’t see Medicare patients, do I still need ICD-10?

Yes. All HIPAA-covered entities must use ICD 10 for services provided on or after Oct. 1, 2015, regardless of whether they treat Medicare or Medicaid patients.

Do ICD-10 codes replace CPT procedure codes?

No. ICD-10-CM/PCS are diagnosis and inpatient procedure codes. CPT codes, maintained by the AMA, continue to be used for outpatient and physician services.

Do I need to learn the entire ICD 10 code set?

Practices should focus on the codes most relevant to their specialty, ensuring documentation supports required specificity. Full mastery of all codes isn’t necessary but knowing your commonly used subsets is critical.

What’s the difference between ICD-10-CM and ICD-10-PCS?
  • ICD-10-CM: Used across all settings for diagnoses; maintained by CDC/NCHS.
  • ICD-10-PCS: Used only for inpatient hospital procedures; maintained by CMS.
Where are the somatic dysfunction codes located in ICD-10-CM?

Somatic dysfunction codes are located in Chapter 13: Musculoskeletal System and Connective Tissue, under category M99, with subcodes from M99.00 to M99.09 indicating specific body regions.

What documentation specificity is needed?

Documentation must support the specificity required by ICD-10, detailing laterality, severity and encounter type (e.g., initial vs. subsequent). Use the ICD-10-CM Official Guidelines and ensure all descriptors are clearly documented.

Back To Top