The Centers for Medicare & Medicaid Services (CMS) released the ICD-10-CM code set update for fiscal year (FY) 2025. These changes include 252 new codes, 36 deletions, and 13 revisions.
These 2025 ICD-10-CM updates are to be used for discharges and patient encounters from October 1, 2024, through September 30, 2025.
These changes will impact medical billing, coding practices, and healthcare administration. Staying abreast of these updates is crucial for medical practices, billing specialists, and healthcare providers to ensure accurate documentation, seamless billing processes, and compliance with regulatory standards.
Let’s review some ICD-10-CM diagnosis code updates you should know:
Chapters 1-5
In Chapter 1, there are no new codes, but there is a minor spelling correction for A77.41 (“chaffeensis”). Chapter 2 sees several codes converted to parent codes and expanded with a fifth character ‘A,’ to indicate cancer “in remission.” On the other hand, Chapter 3 introduces a new code, D61.03, for Fanconi anemia.
Chapter 4 brings several new codes, including those for presymptomatic Type 1 diabetes (E10.A-), hypoglycemia levels (E16.A-), carcinoid syndrome (E34.00-E34.09), obesity class (E66.811-E66.813), disorders of citrate metabolism (E74.82-), and E88.82 for obesity due to disruption of the MC4R pathway.
In Chapter 5, the CMS expanded codes for eating disorders, including new categories for anorexia nervosa, bulimia nervosa, and binge eating disorder. Additionally, the updates include new codes F50.83 for pica in adults and F50.84 for rumination disorder in adults.
Chapters 6-10
Chapter 6 introduces new codes for KCNQ2-related epilepsy (G40.841-G40.844) and serotonin syndrome (G90.81). There are also new codes for other disorders of the autonomic nervous system (G90.889) and developmental and epileptic encephalopathy (G93.45). Chapter 7 revised the H44.2 codes for degenerative myopia to remove the reference to the bilateral “eye.” Regarding Chapter 8, it has no changes for diseases of the ear and mastoid process.
Chapter 9 expands and revises the codes under I26 for pulmonary embolism. Chapter 10 introduces new codes under J21 for nasal valve collapse, specifying the collapse’s location and the condition’s state.
Chapters 11-15
Chapter 11 provides detailed coding for anal, rectal, and anorectal fistulas. Regarding Chapter 12, it includes new codes for cholestatic pruritus (L29.81) and lichen planus. Chapter 13 has expanded codes for musculoskeletal system and connective tissue disorders, including specifics for pain location. Meanwhile, Chapter 14 includes a minor note addition under N39.0 for urinary tract infections. Also, Chapter 15 has noted changes in diabetes mellitus in pregnancy.
Chapters 16-21
The ICD-10 changes for Chapter 16 include adding an Excludes1 note under P72 for other transitory neonatal endocrine disorders. Chapter 17 introduces new codes for congenital malformations of the aortic and mitral valves (Q23.81-Q23.82, Q23.88) and Kleefstra syndrome (Q87.86).
Chapter 18 features a new code for anosognosia (R41.85). Regarding Chapter 19, it introduces the new code T45.A for poisoning by, adverse effect of, and underdosing of immune checkpoint inhibitors and immunostimulant drugs. It also includes new fifth- and sixth-character codes that specify the circumstances of the poisoning, adverse effect, or underdosing. Additionally, under T81.32 for disruption of internal operation (surgical) wound, not elsewhere classified, there are new sixth-character codes (T81.320-T81.329) to specify the wound location.
Chapter 20 does not change for external causes of morbidity, while Chapter 21 introduces new codes for genetic susceptibility to diseases, sepsis aftercare, and social determinants of health.
For more information about these changes, download the tabular order, addendum, code tables, and index on the CMS website.
At Health Prime, we can help you navigate the ICD-10 code updates!
At Health Prime, we understand that keeping up with the ever-evolving landscape of medical coding can be challenging. The upcoming ICD-10 updates, effective October 1, 2024, bring many changes that will impact your medical billing and coding practices. But don’t worry – we’re here to help!
Health Prime provides tailored solutions to streamline billing processes, reduce errors, and improve compliance. Our services include:
- Expert training: Customized training sessions to ensure your staff is well-versed in the latest ICD-10 updates.
- Coding support: Access to our team of certified coders who can assist with complex coding scenarios and ensure accuracy.
- Compliance assistance: Guidance on maintaining compliance with regulatory standards and avoiding potential pitfalls.
- Documentation reviews: Regular audits and reviews to ensure your documentation aligns with the new coding requirements.
Our team of experts is dedicated to ensuring that your practice stays ahead of the curve. We offer comprehensive training and support to help you understand and implement the new codes efficiently.
To learn more about how we can help you navigate the ICD-10 updates and enhance your medical billing processes, contact us at [email protected]. Our team will set up a meeting to discuss how we can maximize your revenue by cutting costs, saving time, and collecting more!
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