Are You Ready for the New Diagnosis Codes?

The ICD-10-CM codes and guidelines for the 2025 fiscal year (FY) have been released. The new codes will become effective on Oct. 1, 2024.

The ICD-10-CM guidelines have minor updates, and include the following:

  • Chapter 2.s – Breast Implant Associated Anaplastic Large Cell Lymphoma had a revision reading “C84.7B, anaplastic large cell lymphoma, ALK-negative, in remission, for BIA-ALCL in remission.”
  • Chapter 2.t – Secondary malignant neoplasm of lymphoid tissue has been updated to note that categories of C81-C85 with a final character identifying “extranodal and solid organ sites” should be assigned, rather than a code for the secondary neoplasm of the affected solid organ.
  • Chapter 4.a.1.a – a guideline for pre-symptomatic Type 1 diabetes mellitus has been added.
  • Chapter 18.i has been updated to include the code range for acute strokes (I60-I63).
  • Chapter 21.c has an update to the categories of Z codes, to include the status of Z17 description, which was expanded to include “and other hormones and factors.”

The FY 2025 diagnosis code release resulted in a total of 74,260 codes. There are 252 additions, 36 deletions, and 13 revisions. The new codes include the following:

  • Multiple lymphoma, in remission codes;
  • Presymptomatic Type 1 diabetes mellitus;
  • Hypoglycemic levels;
  • Carcinoid syndrome;
  • Obesity classes;
  • Expansion of anorexia nervosa, bulimia nervosa, and binge eating;
  • KCNQ2 epilepsy;
  • Degenerative myopia;
  • Internal and external nasal collapse;
  • Expansion of anal and rectal fistula;
  • Expansion of intervertebral disc degeneration (to include associated symptoms); and
  • Expansion of synovitis and tenosynovitis, to include anatomic site.

The Table of Drugs and Chemicals has been updated to include immune checkpoint inhibitors. This chapter also includes dehiscence of gastrointestinal tract, internal operation wound, and deep operation wound.

The Z codes include progesterone receptor status as well as expanded personal history of colonic polyps, which includes type. This chapter includes receptor status of other hormones and sepsis aftercare. The Social Determinants of Health (SDoH) section has been expanded to include insufficient social insurance and welfare support.

I am excited to see the expansion of the obesity codes, to include the obesity classes, which are frequently documented in medical records. The expansion of diabetes to include pre-diabetes Type 1 is interesting. This update also confirms that the SDoH are here to stay, and this data will continue to be important to capture. The biggest guideline change is the addition of guidelines for pre-symptomatic, Type 1 diabetes mellitus.

This code and guideline update will be further discussed during the ICD10monitor  August webinars.

Resources:

https://www.cms.gov/medicare/coding-billing/icd-10-codes/2025-icd-10-cm

Facebook
Twitter
LinkedIn

Laurie M. Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10-CM/PCS Trainer

Laurie Johnson is currently a senior healthcare consultant for Revenue Cycle Solutions, based in Pittsburgh, Pa. Laurie is an AHIMA-approved ICD-10-CM/PCS trainer. She has more than 35 years of experience in health information management and specializes in coding and related functions. She has been a featured speaker in over 40 conferences. Laurie is a member of the ICD10monitor editorial board and is a permanent panelist on Talk Ten Tuesdays

Related Stories

Focus on Screening Codes

Focus on Screening Codes

Now’s the time for to us to schedule those mammograms and colonoscopies we may have been putting off, but it is also a good time

Read More

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Sepsis Sequencing in Focus: From Documentation to Defensible Coding

Sepsis sequencing continues to challenge even experienced coding and CDI professionals, with evolving guidelines, documentation gaps, and payer scrutiny driving denials and data inconsistencies. In this webcast, Payal Sinha, MBA, RHIA, CCDS, CDIP, CCS, CCS-P, CCDS-O, CRC, CRCR, provides clear guideline-based strategies to accurately code sepsis, severe sepsis, and septic shock, assign POA indicators, clarify the relationship between infection and organ dysfunction, and align documentation across teams. Attendees will gain practical tools to strengthen audit defensibility, improve first-pass accuracy, support appeal success, reduce denials, and ensure accurate quality reporting, empowering organizations to achieve consistent, compliant sepsis coding outcomes.

March 26, 2026
I022426_SQUARE

Fracture Care Coding: Reduce Denials Through Accurate Coding, Sequencing, and Modifier Use

Expert presenters Kathy Pride, RHIT, CPC, CCS-P, CPMA, and Brandi Russell, RHIA, CCS, COC, CPMA, break down complex fracture care coding rules, walk through correct modifier application (-25, -57, 54, 55), and clarify sequencing for initial and subsequent encounters. Attendees will gain the practical knowledge needed to submit clean claims, ensure compliance, and stay one step ahead of payer audits in 2026.

February 24, 2026
Mastering Principal Diagnosis: Coding Precision, Medical Necessity, and Quality Impact

Mastering Principal Diagnosis: Coding Precision, Medical Necessity, and Quality Impact

Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.

December 3, 2025

Proactive Denial Management: Data-Driven Strategies to Prevent Revenue Loss

Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.

November 25, 2025

Trending News

Featured Webcasts

Mastering MDM for Accurate Professional Fee Coding

In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.

March 31, 2026

The PEPPER Returns – Risk and Opportunity at Your Fingertips

Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.

March 19, 2026

Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue

Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.

January 29, 2026

AI in Claims Auditing: Turning Compliance Risks into Defensible Systems

As AI reshapes healthcare compliance, the risk of biased outputs and opaque decision-making grows. This webcast, led by Frank Cohen, delivers a practical Four-Pillar Governance Framework—Transparency, Accountability, Fairness, and Explainability—to help you govern AI-driven claim auditing with confidence. Learn how to identify and mitigate bias, implement robust human oversight, and document defensible AI review processes that regulators and auditors will accept. Discover concrete remedies, from rotation protocols to uncertainty scoring, and actionable steps to evaluate vendors before contracts are signed. In a regulatory landscape that moves faster than ever, gain the tools to stay compliant, defend your processes, and reduce liability while maintaining operational effectiveness.

January 13, 2026

Trending News

Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more

Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24