The FY 2026 ICD code update, effective October 1, 2025, introduces significant changes with 487 new codes, 38 revisions, and 28 deletions. This October update is part of the biannual ICD-10 updates—one in April and one in October. While April’s changes are often minor or focused on coding guidelines, the October release typically involves broader structural changes, and this year is no exception.
New Code and Additions to the Code Set
- E11.A – Type 2 diabetes mellitus in remission, allowing providers to more accurately report patients whose Type 2 diabetes has regressed.
Note: E11.A will carry a new “Excludes 1” instruction, meaning it cannot be reported alongside E11.9 (Type 2 diabetes mellitus without complications). - 112 new codes for non-pressure chronic ulcers
- 3 new codes for malignant inflammatory neoplasm of the breast
- 4 new codes for Thyroid Eye Disease (TED)
- Codes related to the Gulf War theater
- T75.830- (Gulf War illness)
- Z77.31 (Contact with and suspected exposure to Gulf War theater)
- New codes addressing multiple sclerosis
- New diagnosis codes related to financial insecurity (part of CMS’s effort to improve data collection on Social Determinants of Health (SDoH)).
Note: These SDoH codes may foreshadow a future revision to the OASIS tool, potentially in 2027.
Revisions and Deletions to Watch Out For
28 deleted codes
Several deletions are replaced with more specific code expansions. For example:
- H01.8 (Other specified inflammations of eyelid) expands into nine new codes
- R10.2 (Pelvic and perineal pain) is now represented by six separate codes, including clarified terms like “lateral abdomen pain,” “lateral flank pain,” and “latus region pain”
38 revised code descriptors, such as:
- L02.212 updated from “cutaneous abscess of back [any part, except buttock]” to include the flank
- Updates in Chapter 19 that revise descriptions of wrist and hand fractures for improved specificity
Tip: Review changes in every ICD-10 chapter except Chapter 8 (Diseases of the ear) and Chapter 22 (Codes for special purposes), where no changes were made
Preparing for Changes
As the FY2026 ICD-10 updates take effect this October 1, it is important that your coding staff is updated on the changes and applies them accordingly. Make sure that all diagnosis codes are:
- Supported by provider documentation
- Accurate for both primary and secondary conditions
- Aligned with PDGM and hospice billing requirements
Staying updated isn’t just about compliance—it ensures proper patient classification, improves data accuracy, and supports optimal reimbursement.
The official guidelines have not yet been released, but this article will be updated once they become available. In the meantime, you can access the available files, including the tabular addenda, at the CMS website.
