With ICD-10-CM 2025 updates just around the corner, it’s important to stay on top of the changes to this critical coding system. Relying on outdated codes almost always leads to denied or delayed reimbursement – but it is possible to ensure accurate clinical documentation and optimize revenue.
In our recent webinar, ICD-10-CM 2025 updates and regulatory readiness, leading coding professionals and industry thought leaders at IMO Health discuss the upcoming ICD-10-CM coding revisions, including key updates across body systems, notable changes to the Index and Tabular, and ICD-10-CM modifier changes.
While April brought some routine maintenance changes within the alphabetic index and tabular, October will see the largest number of changes. At a glance, fiscal year 2025 is a slightly lighter year for new codes with 252 additions, 36 deletions, and 13 codes with revised titles.
To help you prepare for a seamless transition and safeguard your bottom line, we’ve highlighted five key ICD-10-CM updates, effective October 1.
In a hurry? Continue scrolling for a few key insights from this session.
New ICD-10 codes for cancer in remission
Treatment for lymphoma, a cancer of the lymphatic system, revolves around the eradication of malignant lymphocytes to achieve complete remission, or the total absence of detectable disease.
The CDC has created 65 new codes for various lymphoma classifications to identify “in remission status.” For specific types of lymphoma in C86, C88, and C89, new codes were also created to classify lymphomas as “not having achieved remission,” including those that have failed remission.
Additionally, a new code to classify Primary Central Nervous System Lymphoma (PCNSL), a rare and aggressive extranodal form of non-Hodgkin’s lymphoma, is being added this October.
ICD-10 code changes for progression of type 1 diabetes and hypoglycemia
Various studies show that prior to the onset of type 1 diabetes symptoms, there are distinct identifiable stages.
Two new codes have been introduced to capture the stages of presymptomatic type 1 diabetes mellitus. The stages are defined as follows:
Stage 1 TID: Multiple islet autoantibodies with normal plasma glucose and presymptomatic.
Stage 2 TID: Islet autoantibodies with abnormal glucose tolerance, also presymptomatic.
Regarding hypoglycemia – historically, providers have documented the clinical condition subjectively using ‘mild,’ ‘moderate,’ or ‘severe.’ Yet, there are three levels that are adopted as a standard of care by the American Diabetes Association (ADA) and the American Association of Clinical Endocrinology (AACE), each with its own corresponding codes.
The level system now creates an objective classification. Tabular notes have been added to instruct providers to “use additional code” for hypoglycemia level.
Obesity ICD-10 code updates
Obesity is a chronic disease influenced by a mix of social, psychological, biological, and genetic factors. Monogenic obesity is unique in that it is a rare and severe early-onset form. Code E88.82 has been introduced in the metabolic chapter to capture this specific and distinct cause of obesity.
Additionally, a new code for genetic susceptibility to obesity has been created, along with new obesity class codes to classify the severity of the condition. These new codes help to eliminate the use of subjective terminology like ‘severe’ or ‘extreme’ and reduce the use of stigmatizing language like morbid.
Adult obesity class codes start with BMIs over 30, while pediatric obesity classification is determined by age and gender specific percentiles. Specifically, two new codes and a revision to the code title for Z68.54 have been added to represent pediatric BMI.
ICD-10 codes added for eating disorders
Several new ICD-10 codes have been added for the two types of anorexia nervosa (restricting and binge eating/purging type), along with bulimia nervosa and binge eating disorder, to reflect the severity of the conditions—mild, moderate, severe, or extreme. The CDC has also added a new code identifying if the condition is “in remission,” classifying patients with either a partial or full remission.
Additional changes include F50.83 for pica in adults, or the persistent eating of non-nutritive, nonfood substances for at least a month, and F50.84 for rumination disorder in adults, or the repeated regurgitation of food over a period of at least a month that cannot be attributed to an associated gastrointestinal or other medical condition. Code F98.21 had a title revision to add “and childhood.”
Fistula-related ICD-10 code updates
The codes for anal fistula, rectal fistula and ano rectal fistula have been expanded to capture severity and progression. The new codes account for the location of the fistula and whether it’s simple or complex.
Simple anal fistulas have a single external and internal opening and are classified as low intersphincteric or superficial. Complex fistulas can be significantly more challenging to manage and are classified as extraphincteric, high intersphincteric, supraspinteric, and transphincteric by the ICD-10.
