The Center for Medicare and Medicaid Services has released the FY 2026 updates to the ICD-10-CM code classification. There are almost twice as many new codes this year as compared to last year, with the number of codes being added to a single chapter ranging from 1 to 213.
Year | New Codes | Deleted Codes | Revised Code Titles |
2026 | 487 | 28 | 38 |
2025 | 252 | 36 | 13 |
This this table show the breakdown of code updates by chapter of ICD-10-CM.
ICD-10-CM Chapter | New | Revised | Invalid |
Chapter 1: Certain Parasitic and Infectious Diseases | 2 | 0 | 1 |
Chapter 2: Neoplasms | 3 | 0 | 1 |
Chapter 3: Diseases of the Blood and Blood Forming Organs | 3 | 0 | 0 |
Chapter 4: Endocrine, Nutritional and Metabolic Diseases | 23 | 0 | 0 |
Chapter 5: Mental, Behavioral and Neurodevelopmental Disorders | 0 | 0 | 0 |
Chapter 6: Diseases of the Nervous System | 10 | 0 | 1 |
Chapter 7: Diseases of the Eye and Adnexa | 17 | 0 | 1 |
Chapter 8: Diseases of the Ear and Mastoid Process | 0 | 0 | 0 |
Chapter 9: Diseases of Circulatory System | 4 | 0 | 0 |
Chapter 10: Diseases of the Respiratory System | 0 | 0 | 0 |
Chapter 11: Diseases of the Digestive System | 0 | 0 | 0 |
Chapter 12: Diseases of the Skin and Subcutaneous Tissue | 116 | 2 | 0 |
Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue | 1 | 3 | 0 |
Chapter 14: Diseases of the Genitourinary System | 5 | 0 | 0 |
Chapter 15: Pregnancy, Childbirth and the Puerperium | 0 | 0 | 0 |
Chapter 16: Certain Conditions Originating in the Perinatal Period | 0 | 1 | 0 |
Chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities | 23 | 6 | 2 |
Chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified | 21 | 0 | 2 |
Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes | 213 | 24 | 12 |
Chapter 20: External Causes of Morbidity | 20 | 1 | 0 |
Chapter 21: Factors Influencing Health Status and Contact with Health Services | 26 | 1 | 5 |
Chapter 22: Codes for Special Purposes | 0 | 0 | 0 |
Total | 487 | 38 | 28 |
The updates to the ICD-10-CM Official Guidelines for Coding and Reporting are extensive for 2026. The updates include the addition of new guidelines as well as rewording or additions to existing guidelines.
A significant percentage of updates to the guidelines are being made in Chapter 1 to the guidelines for coding for HIV disease.
For this chapter, one new guideline was added, and eight other guidelines have been edited. The additions and wording changes provide clarification and specification around current principles for coding HIV without really changing the coding principles outright.
For example, the title and wording of guideline I.C.2.e.2 was updated to specify that this guideline applies to admissions/encounters involving chemotherapy, immunotherapy and radiation therapy for treatment of a neoplasm/neoplastic disease.
A new guideline was added as the first guideline under the section titled Selection and Sequencing of HIV codes. Adding this guideline at the beginning of the section has pushed the subsequent nine guidelines down in the section causing the numbering of the guidelines to change. Some guidelines have been renamed even if the content of the guideline remained the same.
The new guideline, I.C.1.a.2.a, is titled HIV disease. This guideline clarifies that any documentation of a condition as AIDS, HIV Disease, HIV related illness or any description of a diagnosis resulting from the patient being HIV positive is to be reported with code B20 Human immunodeficiency virus Additional new and updated guidelines are listed below. Each guideline should be reviewed with an eye towards any changes it brings to correct coding practices.
2026 ICD-10-CM Coding Convention Update | |
---|---|
I.A.7 | Punctuation |
2026 ICD-10-CM Coding Guidelines Updates | |
I.B.14 | Documentation by Clinicians Other than the Patient’s Provider |
I.B.20 | Multiple Sites Coding (NEW) |
I.C.4.a.1.b | Type 2 Diabetes Mellitus in Remission (NEW) |
I.C.9.a.1 | Hypertension with Heart Disease |
I.C.9.a.3 | Hypertensive Heart and Chronic Kidney Disease |
I.C.13.a.2 | Multiple Sites (NEW) |
I.C.21.c.3/7/13/17 | Categories of Z Codes – Status/Aftercare/Miscellaneous/SDOH |
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 for a particular search of the index or added new search terms providing a way to locate a code but not due to the introduction of a new code.
Examples:
With the addition of codes for idiopathic, infantile calcification of arteries, the code directed for use by the index changes from a “Q” code (Q28.8) for a congenital condition from chapter 17 to an “E” code (E83.820) from chapter 4, so this condition has been reclassified to a whole different chapter of ICD-10-CM.
New terms have been added leading to code O36.59- to report fetal growth restriction.
Subterms have been added to allow for reporting dactylitis and priapism as complications of sickle-cell disease.
The greatest number of updates to ICD-10-CM for 2026 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, 2025, it is recommended to pay particular attention to reviewing any relevant instructional notes in the Tabular List for applicable changes.
The list below highlights some of the significant 2026 updates to ICD-10-CM by chapter.
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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.