FY 2025 ICD-10-CM Code Updates

The Center for Medicare and Medicaid Services has released the FY 2025 updates to the ICD-10-CM code classification. There are fewer new codes this year compared to last year, but many interesting new codes are being added.

This this table show the breakdown of code updates by chapter of ICD-10-CM.

ICD-10-CM Coding Guidelines

The updates to the ICD-10-CM Official Guidelines for Coding and Reporting are minimal for 2025. Most of the updates are necessary just to maintain consistency in how things are referenced in the guidelines based on the addition of new codes.

For example, the title of category Z17 has been expanded to Estrogen, and other hormones and factors receptor status. This title change means guideline II.C.21.c.3 had to be updated for consistency.

3) Status

Z17 Estrogen, and other hormones and factors receptor status

Z18 Retained foreign body fragments

Z19 Hormone sensitivity malignancy status

However, there is one completely new guideline, I.C.4.a.1.(a) Presymptomatic Type 1 Diabetes Mellitus being added related to the addition of new codes to report presymptomatic type 1 diabetes mellitus. The new guideline simply indicates that codes from subcategory E10.A- are assigned for early-stage, type 1 diabetes that predates the onset of diabetic symptoms.

1) Type of diabetes

The age of a patient is not the sole determining factor, though most type 1 diabetics develop the condition before reaching puberty. For this reason, type 1 diabetes mellitus is also referred to as juvenile diabetes.

(a) Presymptomatic Type 1 Diabetes Mellitus Codes E10.A-, Type 1 diabetes mellitus, presymptomatic, are assigned for early-stage type 1 diabetes that predates the onset of symptoms.

ICD-10-CM Alphabetic Index

Most of the entries added to or deleted from the index are related to the addition of new codes or the addition of new inclusion terms being added under some codes. There are several instances though where the index has changed the code directed for use by a particular search of the index or added search terms leading to a more specific code but not due to the introduction of a new code.

Examples:

When the terms Tumor, stromal, gastric and malignant are searched, the index previously directed the assignment of code C16.9 Malignant neoplasm stomach, unspecified. The index now directs assignment of code C49.A2 Gastrointestinal stromal tumor of stomach.

No Change Tumor - see also Neoplasm, unspecified behavior, by site

Revise from - - - malignant C16.9

Revise to - - - malignant C49.A2

A subterm has been added providing the option to specify rupture of the globe of the eye as nontraumatic.

No Change Rupture, ruptured

No Change - globe (eye) (traumatic) - see Injury, eye, laceration

Add - - nontraumatic (see also Disorder, globe) H44.89

Subterms have been added providing the option to specify stenosis/stricture of the celiac artery as arterio/atherosclerotic.

No Change Stenosis, stenotic (cicatricial) - see also Stricture

No Change - artery NEC (see also Arteriosclerosis) I77.1

Revise from - - celiac I77.4

Revise to - - celiac (compression) I77.4

Add - - - arteriosclerotic I70.8

Add - - - atherosclerosis I70.8

No Change Stricture - see also Stenosis

No Change - artery I77.1

Revise from - - celiac I77.4

Revise to - - celiac (compression) I77.4

Add - - - arteriosclerotic I70.8

Add - - - atherosclerosis I70.8

Subterms have been added providing the option to specify thoracic outlet syndrome as arterial or venous.

No Change Syndrome - see also Disease

No Change - thoracic outlet (compression) G54.0

Add - - arterial I77.89

Add - - neurogenic G54.0

Add - - venous I87.1

ICD-10-CM Tabular List

The greatest number of updates to ICD-10-CM for 2025 were made within the Tabular List. Updates consist primarily of adding new codes or expanding existing codes to provider greater specificity, but there were also a notable number of updates to instructional notes, such as the addition of Code first, Code Also and Use Additional Code notes, and Excludes 1 notes being changed to Excludes 2 notes. When coders begin assigning codes on October 1, 2024, it is recommended to pay particular attention to reviewing any relevant instructional notes in the Tabular List for applicable changes.

2025 ICD-10-CM Significant Updates by Chapter

The list below highlights some of the significant 2025 updates to ICD-10-CM by chapter.

• Chapter 2: Neoplasms
  • The codes in categories C81-C84 now have an option to report “in remission”.
  • The codes in categories C86 and C88 now have options to report “not having achieved remission” or “in remission.”
• Chapter 4: Endocrine, Nutritional and Metabolic Diseases
  • Three new subcategories of codes have been added
    • E10.A- Type 1 diabetes mellitus, presymptomatic
    • E16.A- Hypoglycemia level
    • E66.8 – Obesity class
  • Four additional new codes have been added to this chapter
  • Several subcategories have new instructional notes that direct reporting of additional codes for use of injectable non-insulin antidiabetic drugs (Z79.85) and/or new codes from subcategory E16.A- Hypoglycemia level.
• Chapter 5: Mental, Behavioral and Neurodevelopmental Disorders
  • The codes in category F50 Eating Disorders that report anorexia, bulimia and binge eating have been expanded to specify severity.
  • The diagnoses of PICA and rumination disorder have new codes specifically reporting these conditions in adults. 
    
    
• Chapter 11: Diseases of the Digestive System
  • Codes in category K60 Fissure and fistula of anal and rectal regions have been expanded to specify complexity and nature of occurrence. Several instructional notes have also been added directing the assignment of codes for associated diagnoses.
    
    
• Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue
  • Codes for lumbar and lumbosacral intervertebral disc degeneration (M51.36 and M51.37) have been expanded to specify type of pain as
    • discogenic back pain only
    • lower extremity pain only
    • discogenic back pain and lower extremity pain
    • without mention of lumbar back pain or lower extremity pain
  • Excludes 1 notes have been added excluding these codes from being reported with codes M54.3, M54.4 and M54.5.
  • Code M65.9 Synovitis and tenosynovitis has been expanded to include specification of site and laterality. 
    
    
• Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes
  • Category T45 Poisoning by, adverse effect of and underdosing of primarily systemic and hematological agents, NEC is getting 6 new codes to report poisoning by, adverse effect of and underdosing of immune checkpoint inhibitors and immunostimulant drugs.
  • Code T81.32 Disruption of internal operation (surgical) wound, not elsewhere classified is being expanded to include four new codes to provide greater specificity in reporting disruption or dehiscence of internal operation or surgical wounds..
  • Various instructional notes related to these two groups of new codes can be found in the Tabular List for Chapter 19 and other chapters of ICD-10-CM.
    
    
• Chapter 21: Factors Influencing Health Status and Contact with Health Services
  • Category Z17 is being updated from Estrogen receptor status to Estrogen, and other hormones and factors receptor status and 8 new codes are being added to indicate positive/negative receptor status and/or combined receptor status.
  • A new subcategory of codes has been added
    • Z67.A- Duffy phenotype
  • Other updates to Z codes that include new or revised codes include
    • Z15.- genetic susceptibility to disease
    • Z51.A Encounter for sepsis aftercare
    • Z59.7- Insufficient social insurance and welfare support
    • Z68.5- Body mass index [BMI] pediatric
    • Z83.72 Family history of familial adenomatous polyposis
    • Z26.101- Personal history of colonic polyps

Prepare Now

Make sure you and your team are ready on October 1, 2024, to apply all of the FY2025 code updates! Register now to enroll in HIALearn’s FY 2025 Code Update Series, including:

FY 2025 ICD-10-CM Code Updates

FY 2025 ICD-10-PCS Code Updates

FY 2025 Inpatient Prospective Payment System (IPPS) Updates

Bundled pricing available! Don’t miss out! Register for these essential courses by going to HIAlearn.com/code-updates

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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.