BEWARE: Fifty New ICD-10-PCS Codes are Coming!

While we think of Oct. 1 as the date we look for new ICD-10 codes and changes, in the past few years we have seen an additional update on April 1. This year, 2025, will be no exception.

The Centers for Medicare & Medicaid Services (CMS) has announced an expansion of an additional 50 ICD-10-PCS codes. These new codes will be effective for procedures that are performed between April 1, 2025 through Sept. 30, 2025. This will take us right to Oct. 1, 2025, when we will get our update for the 2026 fiscal year (FY).

The 50 new codes include both operating room (OR) and non-OR procedures. Among the non-OR procedures is code D228DZZ – Stereotactic other photon radiosurgery of conduction mechanism. While this is designated as a non-OR procedure, the update indicates that it affects MS-DRG assignment. This code is an add-on in the Radiation Therapy section, with new body system and treatment site values. If your facility performs this stereotactic photon radiosurgery, be sure to check the update and watch for this on and after April 1. The other new non-OR procedures include an endoscopic trachea bypass, cervix dilation, and open introduction of therapeutic substance into joints, as well as some new technology codes involving monoclonal antibodies, antineoplastics, and a whole blood cellular assessment for measurement of immune response.

The remainder of the new codes, a majority of them, are designated as OR procedures. There are new codes for both allogeneic and syngeneic transplantation of the larynx performed via an open approach. Also included are new codes for transfer of the small intestine to the vagina by either an open or percutaneous endoscopic approach.

There are several new codes for resection of both the right and left kidney, performed by an open approach. With these new kidney resection codes, we see allogeneic, syngeneic, and zooplastic options. There is a new code for extraction of retained products of conception via an open approach as well. 

New technology Group 10 codes make up the rest of the new OR procedures. These include codes for bypass of the left atrium and supplement of the right atrium. Codes for reposition of the humeral shaft, radius, ulna, upper and lower femur, femoral shaft, and tibia are also included.

This update also notes MS-DRG Grouper and ICD-10 Medicare Code Editor (MCE) Version 42.1, which will be used for discharges on or after April 1, 2025. It also notes that Java 8, which both the MS-DRG Grouper and the MCE currently use, will not be supported after November 2026. Java 17 will be used, effective October 2025, with the FY 2026 release. Transition preparation details are noted listing the site GrouperBetaTesting@cms.hhs.gov, where questions can be directed regarding the Java conversion.

You can visit https://www.cms.gov/Medicare/Medicare-Fee-For-Service-Payment/AcuteinpatientPPS/MS-DRG-Classifications-and-Software.html for the ICD-10-MS-DRG V42.1  for Grouper Software, Definitions/Manual Table of Contents, and the Definitions of Medicare Code Edits V42.1.

Visit https://www.cms.gov/medicare/coding-billing/icd-10-codes for the Code Tables, Index, and related Addenda files for the 50 new ICD-10-PCS codes. 

Programming note:

Listen live to Christine Geiger when she reports the latest coding news on Talk Ten Tuesday with Chuck Buck and Angela Comfort, 10 Eastern.