ICD-10-CM Updates for FY 2025 By CMS

Get ready for some thrilling updates! The ICD-10-CM code set has just been revamped for fiscal year (FY) 2025, and the new changes are live on the Centers for Medicare & Medicaid Services (CMS) website as of July 3. These 2025 ICD-10-CM codes are to be used for resident stays occurring from October 1, 2024, through September 30, 2025. The update includes 252 new codes, 36 code deletions, and 13 code revisions. 

Mark your calendars—these updates take effect on October 1 and bring a whirlwind of new codes, deletions, and revisions to the diagnosis code set!

Here’s a high-energy preview of what’s in store:

Dx Code Changes by Chapter:

Chapter 1 – While there are no new codes for certain infectious and parasitic diseases, we’ve got a spelling fix in A77.41 for “chaffeensis.”

Chapter 2 – Brace yourself for a cancer code explosion! Several codes are now parent codes with a new fifth character ‘A’ to show cancer “in remission.” For instance, C81 Hodgkin Lymphoma now has seven new codes detailing remission types (C81.0A-C81.9A).

Chapter 3 – Just one hot new addition: D61.03 for Fanconi anemia.

Chapter 4 – Dive into the updates under E10 Type 1 diabetes mellitus with fresh codes for presymptomatic diagnoses (E10.A-), hypoglycemia levels (E16.A-), carcinoid syndrome (E34.00-E34.09), obesity classes (E66.811-E66.813), disorders of citrate metabolism (E74.82-), and E88.82 Obesity due to MC4R pathway disruption!

Chapter 5 – The eating disorders section is bursting with new codes! Find fresh details for anorexia nervosa, binge eating/purging type, bulimia nervosa, and binge eating disorder. Plus, new codes for pica (F50.83) and rumination disorder in adults (F50.84).

Chapter 6 – Epilepsy and recurrent seizures are getting a major upgrade! New codes include G40.84 KCNQ2-related epilepsy, plus child codes for intractable seizures with status epilepticus. We’re also seeing new entries for serotonin syndrome (G90.81) and other autonomic nervous system disorders (G90.889).

Chapter 7 – Five new fifth-character codes under H44.2 for degenerative myopia are fine-tuned to eliminate references to bilateral “eye.”

Chapter 8 – No changes here for ear and mastoid process diseases (H60-H95).

Chapter 9 – The Pulmonary embolism subcategory I26 expands with four new codes (I26.03-I26.04, I26.95-I26.96) and two revised codes (I26.93-I26.94) to include “thrombotic.”

Chapter 10 – Acute bronchiolitis (J21) sees several new codes for nasal valve collapse, detailing collapse locations and conditions with precision!

Chapter 11 – New fifth- and sixth-character codes under K60.3, K60.4, and K60.5 now let you report anal and rectal fistulas in intricate detail, covering whether they’re simple or complex and their status (initial, persistent, recurrent).

Chapter 12 – The pruritus codes under L29 now include new codes for cholestatic pruritus (L29.81) and other pruritus (L29.89). Plus, Lichen planus (L43) gets six new fifth-character codes to detail lichen planopilaris and central centrifugal cicatricial alopecia!

Chapter 13 – There are several new codes for diseases of the musculoskeletal system and connective tissue. Under M51 Thoracic, thoracolumbar, and lumbosacral intervertebral disk disorders, there are new six-character codes that allow the practitioner to specify the location of pain more succinctly. And under subcategory M65 Synovitis and tenosynovitis, several fifth- and sixth-character codes are added to allow the practitioner to specify the location of the unspecified synovitis and tenosynovitis.

Chapter 14 – Other than the addition of an Excludes1 note under N39.0 Urinary tract infection, site not specified, there’s nothing exciting going on here.

Chapter 15 – This chapter has a few note changes to codes in subcategory O24 Diabetes mellitus in pregnancy, childbirth, and the puerperium.

Chapter 16 – There is the addition of one Excludes1 note under P72 Other transitory neonatal endocrine disorders.

Chapter 17 – In this chapter, there are three new codes for congenital malformations of aortic and mitral valves (Q23.81-Q23.82, Q23.88) and one new code for Kleefstra syndrome (Q87.86).

Chapter 18 – You’ll find one new code here for anosognosia (R41.85). Patients with this condition are unaware of their health conditions or problems, often due to dementia or Alzheimer’s.

Chapter 19 – Under subcategory T45 Poisoning by, adverse effect of an underdosing of primarily systemic and hematological agents, not elsewhere classified, there is new code T45.A Poisoning by, adverse effect of and underdosing of immune checkpoint inhibitors and immunostimulant drugs, followed by several new fifth- and sixth- character codes that specify the circumstances of the poisoning, adverse effect, or underdosing. And under T81.32 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 – There are no changes in this chapter for external causes of morbidity.

Chapter 21 – In this final chapter of ICD-10-CM, there are new codes for reporting genetic susceptibility to various diseases such as epilepsy and neurodevelopmental disorders (Z15.1) and obesity (Z15.2). Additionally, the descriptor for subcategory Z17 is revised to expand the scope of hormones to include progesterone and human epidermal growth factor and to specify receptor status. Also new for FY 2025:

  • Z51.A Encounter for sepsis aftercare;
  • Two new social determinants of health codes for insufficient health insurance coverage (Z59.71) or welfare support (Z59.72);
  • Several codes (Z67.A-) for identifying blood types using the Duffy blood group system;
  • Two codes (Z68.55-Z68.56) for identifying pediatric body mass index percentiles;
  • A code for reporting family history of familial adenomatous polyposis (Z83.72); and
  • Four codes for reporting a personal history of specific types of colon polyps (Z86.0100-Z86.0102, Z86.0109).

Note: There are additional changes within the Alphabetic Index and Tabular list, such as revisions, inclusion terms, and parenthetical notes, which are not covered in this article.

External Cause of Injuries Index

Hold onto your hats—there are some thrilling updates in the ICD-10-CM External Cause of Injuries index! Sections A, E, P, and R are buzzing with revisions, additions, and deletions that will definitely catch your eye:

Section A – Get ready for the latest on assault entries with updates to homicidal (by) (in) Y09!
Section E – Explosions and exposures are getting their due with fresh details on accidental explosions (W40.9) and exposure (X58).
Section P – Powder burns and the nuances of recoil are now more precisely outlined.
Section R – The section on rape (attempted) is updated with new specifics (T74.2-), alongside refinements in recoil descriptions.

Many of these changes are polishing up typographic errors—“hangun” is now “handgun” and “firearn” is corrected to “firearm.”

Note: Don’t worry about typographical errors lingering in code files released by CMS—they’re usually cleaned up in code books published by AAPC!

Table of Drugs

Excitement abounds in the ICD-10-CM Table of Drugs and Chemicals! New entries are set to make a splash:

– Hydroxyzine now includes “antiallergic,” reported with T45.0X-.
– Immune section gets a boost with “checkpoint inhibitors” (T45.AX-) and “immunostimulant drugs” (T45.AX-).

These additions will require a six-character code to specify the circumstances of the poisoning—talk about detailed precision!

Table of Neoplasms

A single but impactful revision is rolling out in the ICD-10-CM Table of Neoplasms for FY 2025. The entry for “odontogenic – see Neoplasm, jaw bone” is now updated to “odontogenic – see Neoplasm, jaw, bone.” A perfect example of how a comma can make all the difference!

Guidelines

Get ready for some subtle but significant changes in the ICD-10-CM Official Guidelines for Coding and Reporting:

– Section I.C.1.d.5(b) adds T81.49 and O86.09 to the lineup of sepsis codes that should be sequenced first.
– Section I.C.2.e.(2) reinforces that if a patient’s admission/encounter is primarily for chemotherapy, immunotherapy, or external beam radiation therapy, specific coding rules apply.
– Section I.C.2.s introduces C84.7B for breast implant-associated anaplastic large cell lymphoma, while Section I.C.2.t updates the guidelines for secondary malignant neoplasm of lymphoid tissue.
– Section I.C.4.1(a) now includes guidance for E10.A- Type 1 diabetes mellitus, presymptomatic.
– Section I.21.C.3 incorporates a revision for the descriptor change to Z17.

Buckle up for these updates—they’re sure to bring a new level of clarity and precision to your coding adventures!

Get ready to dive into these exciting updates and make sure you’re on top of the latest in ICD-10-CM coding!

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