CMS released the 2026 ICD-10-CM® code set effective October 1, 2025. This update includes 614 new codes, 28 deletions and 38 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. Please document carefully:
• Abdominal and pelvic pain section has addition of codes to specify laterality and include flank pain/tenderness and pelvic/perineal pain.
• New designation added for inflammatory breast cancer to better specify malignant neoplasms of breast.
• New codes under eye and adnexa, including designations for eyelid inflammation by location and thyroid orbitopathy
• Many new codes for non-pressure, chronic ulcers by severity and location
• Added genetic susceptibility of malignancy codes for fallopian tubes, urinary tract, and digestive system to include colorectal cancer.
CMS has updated several NCDs to include the ICD-10 changes. MM14153 - Laboratory National Coverage Determination Edit Software Updates: October 2025
APS will continue to provide feedback on coding or documentation issues found commonly amongst our client base.
CPT copyright 2025 American Medical Association. All rights reserved.
