ICD-10-PCS Code Updates - April 1, 2026

CMS has released the updates to the ICD-10-PCS classification and MS-DRG grouper (V43.1) that become effective on April 1, 2026. This Coding Tip covers the updates to the classification including additions, deletions and changes made in the Code Tables and Official Guidelines for Coding and Reporting.

To ensure you are current on all ICD-10 code updates, make sure you read our related Coding Tip, ICD-10-CM Code Updates - April 1, 2026.

Where can I find the updates?

To download the updated files, use this link to the CMS website: https://www.cms.gov/medicare/coding-billing/icd-10-codes#. The files include the guidelines, the index and the code tables as well as an addendum with files that include only the specific changes being made to the classification. Reviewing the addendum makes it easy to see exactly what is being changed/updated.

Visit New ICD-10-PCS Codes Valid April 1 2026.pdf for a complete list of the 80 new ICD-10-PCS codes along with their OR designation, MDC, and MS-DRG.

ICD-10-PCS Code Updates

The April 1, 2026, update includes changes to 17 code tables across six sections of ICD-10-PCS with the greatest number of new codes being added to the Medical and Surgical and Physical Rehabilitation and Diagnostic Audiology sections.

Here is a summary of the April 1, 2026, changes:

Medical and Surgical (Section 0)

The are 4 code tables in the Medical and Surgical section of ICD-10-PCS that have updates and 1 new table that is being added.

02H Medical and Surgical, Heart and Great Vessels, Insertion

• A new row was added to this table to allow for reporting of Insertion (H) of Pacemaker Cardiac Lead (J), Defibrillator Cardiac Lead (K), Cardiac Lead (M), Intracardiac Pacemaker (N) or Other Device (Y) in the Ventricular Septum (M) via a Percutaneous (3) approach.

0DD Medical and Surgical, Gastrointestinal System, Extraction

• A new row added to this table allows reporting of Extraction (D) of the Omentum (U) or Mesentery (V) via an Open (0) or Percutaneous Endoscopic (4) approach.

0F9 Medical and Surgical, Hepatobiliary System and Pancreas, Drainage

• Two new Qualifier values, Transmural (D) and Transpapillary (E) were added to this table for the body parts Gallbladder (4), Pancreas (G), Hepatic Duct, Right (5), Hepatic Duct, Left (6), Hepatic Duct, Common (7), Cystic Duct (8), Common Bile Duct (9), Ampulla of Vater (C), Pancreatic Duct (D) and Pancreatic Duct, Accessory (F), but only when they are drained Via Natural or Artificial Opening Endoscopic (8) approach.

0TX Medical and Surgical, Urinary System, Transfer

• This new code table allows for reporting of Transfer (X) of the Bladder (B) to take over the function of the Right Ureter (6) or Left Ureter (7) via an Open (0) or Percutaneous Endoscopic (4) approach.

0VT Medical and Surgical, Male Reproductive System, Resection

• A new Qualifier value was added to this table to allow for reporting of Resection (T) of the Prostate (0) with the Capsule Intact (E).

Administration (Section 3)

There are 2 code tables in the Administration section of ICD-10-PCS with updates.

302 Administration, Circulatory, Transfusion

• The row that allowed for reporting of Embryonic Stem Cells (A) through either a Peripheral Vein (3) or Central Vein (4) has been deleted from this table.

3E0 Administration, Physiological Systems and Anatomical Regions, Introduction

• Substance value Stem Cells, Embryonic (A) was added to the rows of the table for the body system/regions Peripheral Vein (3) or Central Vein (4) through a Percutaneous (3) approach.

Note: the changes to the tables in this section are related and indicate the root operation for the administration of embryonic stem cells has changed from Transfusion to Introduction.

Measurement and Monitoring (Section 4)

There is 1 code table with updates in the Measurement and Monitoring section.

4A0 Measurement and Monitoring, Physiological Systems, Measurement

• A new row is being added to this table for the body system Musculoskeletal (F) to report measurement of Body Composition (E) by Air Displacement Plethysmography (J). The only approach value in this row is External (X).

Extracorporeal or Systemic Assistance and Performance (Section 5)

The Extracorporeal or Systemic Assistance and Performance section of ICD-10-PCS has updates to 1 table.

5A0 Extracorporeal or Systemic Assistance and Performance, Physiological Systems, Assistance

• A new qualifier of Blood Flow Modulator (E) is being added to this table to allow reporting of Assistance (0) with Cardiac (2) Output (1) using blood flow modulator, Continuous (2).

Physical Rehabilitation and Diagnostic Audiology (Section F)

The Physical Rehabilitation and Diagnostic Audiology section of ICD-10-PCS has only 2 code tables with updates, but these updates produce 23 new codes.

F07 Physical Rehabilitation and Diagnostic Audiology, Rehabilitation, Motor Treatment

• The body part character values for the Integumentary System:
  • Head and Neck (D)
  • Upper Back/Upper Extremity (F)
  • Lower Back/ Lower Extremity (G)
  • Whole Body (H)

• And for the type qualifiers:

  • Range of Motion and Joint Mobility (0)
  • Muscle Performance (1)
  • Coordination/Dexterity (2)
  • Motor Function (3)
  • Therapeutic Exercise (6)
  • Manual Therapy Techniques (7)

have been moved to their own rows to accommodate the addition of a new row with characters to allow for reporting of Electrotherapeutic (D) treatment of Integumentary System (D-H), using Microcurrent Stimulation (0).

F08 Physical Rehabilitation and Diagnostic Audiology, Rehabilitation, Activities of Daily Living Treatment

• Two new body systems are being added to allow for reporting of Wound Management (5) in the Integumentary System – Thorax and Abdomen (E) and the Musculoskeletal System – Thorax and Abdomen (P).

New Technology (Section X)

The New Technology section of ICD-10-PCS has updates to 4 existing code tables and the addition of 2 new code tables.

X27 New Technology, Cardiovascular System, Dilation

• A new row was added to this table to report Percutaneous (3) Dilation (7) of the Inferior Vena Cava and Iliocaval Confluence (2) with an Open-structure Polymer Lattice Intraluminal Device (C).

X2H New Technology, Cardiovascular System, Insertion

• In this table a row has been added to introduce the body parts Ventricular Septum (M) and Ventricle, Right (V) along with a device value of Defibrillator Lead, Lumenless Small-diameter (G). The only approach value for this row is Percutaneous (3).

Interestingly, a value of (M) was assigned for the body part Ventricular Septum, even though a value of (M) has already assigned to the body part Axillary Artery, Left in a different row of this code table. This use of duplicate values for the body part character means it is necessary for another character value in the code to be used as a differentiator. In the case of code table X2H, a difference in the Device character value or the Qualifier character value can be used for this purpose. In instances where there are two options for a specific character value, the coder will just pick the option that corresponds to the documentation they are coding.

X2K New Technology, Cardiovascular System, Bypass

• Two rows were added to this table to accommodate the addition of a new device, Autologous Cell Seeded Tissue Engineered Resorbable Scaffold to Pulmonary Artery (F) along with body parts Inferior Vena Cava (0) and Hepatic Vein (G). The only approach available for these rows is Open (0).

X9H New Technology, Ear, Nose, Sinus, Insertion

• This is a new table that allows for reporting Insertion (H) of a Temporary Infusion Device (1) in the Inner Ear, Right (D), Left (E), or Bilateral (F).

XU7 New Technology, Female Reproductive System, Dilation

• This is a new table that allows for reporting Dilation (7) of the Vagina (G) with a Temporary Electromechanical Intraluminal Device (1).

XW0 New Technology, Anatomical Regions, Introduction

• For both body parts Peripheral Vein (3) and Central Vein (4) two new substance characters, Alpha1-proteinase Inhibitor (0) and Anitocabtagene Autoleucel Immunotherapy (1), have been added for New Technology Group 11 (B).
• For body part Peripheral Artery (5) a new substance character, Stem Cell, Somatic, has been added for New Technology Group 11 (B).
• A new row was added to this table to report Percutaneous (3) Introduction (0) of CPI-601 Enzyme Replacement Therapy (2) in a Cerebral Ventricle (5).
• A new row was added to this table to report Percutaneous (3) Introduction (0) of DB-OTO via Intracochlear Infusion (3) in the Ear(s) (5).

For more detailed information about the procedures, technologies, devices and/or substances being added to ICD-10-PCS for April 1, 2026, please refer to the Fall 2025 ICD-10 Coordination and Maintenance Committee Update files.

Official Guidelines for Coding and Reporting

There are no updates to the ICD-10-PCS coding guidelines included in the April 1, 2026, updates.

Note: There are also updates to the Alphabetic Index and the ICD-10-PCS Character Definitions, so coders should download all the files from the CMS.gov website referenced previously to have a complete copy of the changes/updates going into effect on April 1, 2026, to use as a reference when coding.

References

• https://www.cms.gov/medicare/coding-billing/icd-10-codes#
• https://www.cms.gov/files/document/icd-10-ms-drg-v43-1-effective-april-1-2026.pdf

Since 1992, HIA has been the leading provider of compliance audits, coding support services and clinical documentation audit services for hospitals, ambulatory surgery centers, physician groups and other healthcare entities. HIA offers PRN support as well as total outsource support.

The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.