CMS released the 2025 ICD-10-CM® code set effective October 1, 2024. This update includes 252 new codes, 36 deletions and 13 revisions, and includes increased specificity, guidelines or other code revisions. Report documentation should be as specific as possible to support diagnosis coding and facilitate quick and clean claim submission.
Key updates for pathologists and radiologists:
• Several new 5th and 6th characters codes added under K60 for anal, rectal, and anorectal fistulas. The new characters allow more specificity for practitioners to report whether the condition is simple or complex and identify initial, persistent, or recurrent conditions. Please indicate this in the documentation as often as possible.
• Pulmonary Embolism expanded to specify causes of cement or fat embolism
• Site specification added to unspecified synovitis and tenosynovitis
• Several updates to further specify types of lymphoma and expanded codes to identify cases in remission
• Hypoglycemia and Obesity are both further specified into levels 1-3
• New Z codes to indicate PR and HER-2 status, coded with breast cancer diagnoses
• Personal history code for colon polyps expanded to specify adenomatous/serrated, hyperplastic, or other colon polyps
CMS has updated several NCDs to include the ICD-10 changes. MM13672 - Changes to the Laboratory National Coverage Determination Edit Software: October 2024 Update (cms.gov)
APS will continue to provide feedback on coding or documentation issues found commonly amongst our client base.
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