Understanding the 2025 ICD-10 codes
We all know that reporting the right ICD-10-CM diagnosis codes helps promote clean claims. And although you may generally know what those codes are for your medical specialty, keep in mind they change annually every October 1. That’s when new, revised, and deleted ICD-10-CM diagnosis codes take effect. Medical coding updates can be tricky, and the 2025 ICD-10 codes are no different. Some medical codes stay the same, but many become more specific, or code descriptors change to include new clinical terms. Other medical codes become invalid, and payors won’t accept them.
Understanding the 2025 ICD-10 code update
It’s important to understand the 2025 ICD-10 code update that includes 252 additions, 36 deletions, and 13 revisions. Why? It’s all about ensuring coding and billing compliance that leads to revenue integrity. It’s also about providing researchers and even your own medical practice with richer medical coding data for analysis and patient care improvement.
Here’s a specialty-by-specialty breakdown of what’s new with the 2025 ICD-10 codes.
Oncology
Review Chapter 2 (neoplasms) for new lymphoma codes that identify ‘in remission.’ Note that there are 63 new 2025 ICD-10 codes in this chapter, making it the one with the most changes.
Hematology
Review Chapter 3 (diseases of the blood and blood-forming organs) for one new code for Fanconi anemia, a rare, inherited disease that, over time, causes bone marrow failure.
Endocrinology
Review Chapter 4 (endocrine, nutritional, and metabolic diseases) for new codes for presymptomatic type 1 diabetes mellitus, hypoglycemia levels, carcinoid syndrome obesity class, and more.
Mental health
Review Chapter 5 (mental, behavioral, and neurodevelopmental disorders) for new codes for anorexia, bulimia, and binge-eating disorders.
Neurology
Review Chapter 6 (diseases of the nervous system) includes new codes for KCNQ2-related disorder, serotonin syndrome, other disorders of the autonomic nervous system, and developmental and epileptic encephalopathy.
Cardiology
Review Chapter 9 (diseases of the circulatory system) for new codes for cement or fat embolism of pulmonary artery.
Pulmonology
Review Chapter 10 (diseases of the respiratory system) for new codes for nasal valve collapse.
Gastroenterology
Review Chapter 11 (diseases of the digestive system) for new codes for anal fistula.
Dermatology
Review Chapter 12 (diseases of the skin and subcutaneous tissue) for new codes for cholestatic pruritus and alopecia.
Orthopedics
Review Chapter 13 (diseases of the musculoskeletal system and connective tissue) includes new codes for discogenic low back pain, multifidus muscle dysfunction, synovitis, and tenosynovitis.
Primary care
Review Chapter 21 (factors influencing health status and contact with health services) for new codes for sepsis aftercare, insufficient health insurance coverage, welfare support, personal history of specific types of colon polyps, family history of familial adenomatous polyposis, and more.
Noting other important medical coding changes
The 2025 ICD-10 code update also include many other changes, including new codes for congenital malformations of aortic and mitral valves, a new code for anosognosia, new codes for pediatric obesity body mass index, and much more.
Next steps
The good news is that you’ve got about a month to prepare for the 2025 ICD-10 codes. But you need to act quickly and understand relevant medical coding updates. Here are the five most important steps to take when preparing for the 2025 ICD-10 code update:
Dig into the codes. You can access the 2025 ICD-10 codes on CMS’ FY 2025 ICD-10CM website or you can download the 2025 ICD-10 codes in the FY 2025 Inpatient Prospective Payment System (IPPS) proposed rule. Click here and then download Table 6A for new diagnosis codes, Table 6C for invalid diagnosis codes, and Table 6E for revised diagnosis codes. Look at your specialty-specific codes, but also consider browsing the other changes to be sure there isn’t something that could affect your payments.
Alert everyone to the medical coding changes. This includes anyone who documents in the medical record, assigns medical codes, queries clinical information, or uses coded data regularly. Ensure they’re aware of the 2025 ICD-10 code update and how it will affect the medical practice.
Ensure your electronic health record vendor is up to date. Templates and practice management systems, for example, should include all of the new and revised 2025 ICD-10 codes. Invalid codes should be deleted.
Communicate with payers. Inquire about any coverage-related changes, changes to prior authorizations, or documentation-related changes that correspond with the 2025 ICD-10 code update.
Go live, then monitor. During the fourth quarter, keep a close eye on denials due to an incorrect diagnosis code. You may need to provide additional medical coding education, perform coding audits, or redesign your clinical documentation improvement workflows.
Looking ahead
October 1 can be a daunting time as you familiarize yourself with 2025 ICD-10 codes. However, it’s also an exciting time for medical practices to capture more detailed clinical information and leverage coded data in new ways. Learn how edgeMED can help.
