Key Takeaways from the FY 2025 ICD-10-CM Code Updates

The ICD-10-CM code updates for the 2025 fiscal year (FY), which took effect Oct. 1, featured more than 300 code changes that reflect ongoing advancements in clinical documentation and disease specificity.

Released by the Centers for Medicare & Medicaid Services (CMS) in July, this latest update is significant and includes 252 new codes, 13 deletions, and 36 revisions, along with minor revisions to the Official Guidelines for Coding and Reporting, that coding professionals will need to integrate into their coding workflows.

As discussed in our e-book, FY2025 ICD-10-CM Code Updates, some of the most significant changes apply to coding of neoplasms (C00-D49), including the addition of 63 new codes to specify when lymphoma is in remission. Most are classified as complications and comorbidities (CCs), which were expanded with fifth character “A” to indicate cancer “in remission.”

These new diagnosis codes provide specificity for the distinct types of lymphoma in remission, allowing for meaningful comparison to assess statistical data, patient care, clinical outcomes, and resource consumption. Following are a few examples of the new code additions:

Code Description

Here are 10 additional takeaways and insights from the FY 2025 updates:

1. Diabetes Updates: Three new ICD-10-CM diagnosis codes (E10.A10-E10.A12) for presymptomatic Type 1 Diabetes were added to capture early-stage diagnosis, highlighting the importance of recognizing diabetes before symptoms appear. Three new codes were also added for hypoglycemia levels (E16.A1-E16.A3).
   
   
2. Personal History of Polyps: Four new codes were added to expand the ICD-10-CM code set for personal history of polyps, which can be grouped as non-neoplastic (typically non-cancerous) and neoplastic (have the possibility to develop cancer). The new codes (Z86.0100-Z86.0102 and Z86.0109) will provide coding specificity for personal history of polyps to identify individuals with risk factors.
   
   
3. Fanconi Anemia: A rare genetic disorder, Fanconi anemia, now has its own ICD-10-CM diagnosis code (D61.03), enabling better tracking of this condition, which affects bone marrow and increases malignancy risk. This condition is classified as a CC for FY 2025.
   
   
4. Obesity Classifications: Four new ICD-10-CM diagnosis codes (E66.811-E66.89) specify various classes of obesity, which will allow for better management and tracking of obesity’s impact on health.
   
   
5. Eating Disorders: Enhanced specificity in eating disorder ICD-10-CM diagnosis codes (F50.010-F50.029) now differentiates between restricting and binge-purge types of anorexia, providing greater clarity for clinicians. Codes also specify if anorexia is mild, moderate, severe, or extreme.
   
   
6. KCNQ2-Related Epilepsy: Four new codes (G40.841-G40.844) for KCNQ2-related epilepsy allow clinicians to document and treat this genetic childhood epilepsy with more precision, improving patient outcomes. KCNQ2-related epilepsy is one of the most common genetic epilepsy syndromes in childhood. KCNQ2 is not the name of a medical condition, but of the gene that is affected.
   
   
7. Pulmonary Embolism Expansion: Four new codes for fat and cement pulmonary embolism (I26.03-I26.04 and I26.95-I26.96) facilitate better distinction and treatment. Cement pulmonary embolism is a complication that can occur when polymethyl methacrylate (PMMA), a type of acrylic cement, leaks into the pulmonary arteries during procedures like vertebroplasty or kyphoplasty. PMMA is often used in these minimally invasive procedures to treat vertebral fractures, or with knee and hip arthroplasty procedures. The cement can leak into the veins and then into the pulmonary arteries.
   
   
8. Nasal Valve Collapse (NVC): Seven new codes for nasal valve collapse (J34.8200-J34.8202, J34.8210, J34.8211, J34.8212, and J34.829) were introduced to differentiate between internal of external, and if the collapse is static or dynamic. NVC is defined as a weakness or narrowing of the internal or external nasal valves. Symptoms associated with NVC, either static or dynamic, may include difficulty in nasal inspiration, exercise intolerance, sleep disturbance, and decreased quality of life.
   
   
9. Congenital Heart Conditions: New codes for bicuspid aortic valve (Q23.81) and other congenital heart malformations (Q23.82 and Q23.88) help clinicians track these conditions’ progression and potential complications. For new code Q23.81, there is a tabular note to also code (if applicable) acquired aortic valve disorders, such as: aortic insufficiency (I35.1), aortic stenosis (I35.0), and aortic stenosis with insufficiency (I35.2).
   
   
10. Immune Checkpoint Inhibitors: Eighteen new codes were created to track poisoning, adverse effects, and underdoing of immune checkpoint inhibitors, an expanding cancer therapy that can have severe side effects across multiple organ systems. Some of the common immune checkpoint inhibitors include Pembrolizumab (Keytruda), nivolumab (OPDIVO), avelumab (Bavencio), durvalumab (Imfinzi), and Ipilimumab (Yervoy).

These updates reflect the continuous evolution of medical coding to match advancements in medical practice, patient care, and research. As medical coding professionals, it is our responsibility to keep current with the annual code changes and understand how to apply them correctly on medical coding to match advancements in medical practice, patient care, and research. As medical coding professionals, it is your responsibility to keep up to date with the annual code changes and understand how to apply them correctly with Oct. 1, 2024, discharges/dates of service.

Programming note:

Listen to senior healthcare professional Leigh Poland when she reports this story live today during Talk Ten Tuesday with Chuck Buck at 10 Eastern.