At a Glance
- The Centers for Medicare & Medicaid Services (CMS) announced new, revised, and deleted ICD-10-CM medical codes for fiscal year (FY) 2025 which took effect on October 1, 2024, requiring medical practices to quickly adapt.
- The 2025 ICD-10 code changes include 252 additions, 36 deletions, and 13 revisions across various chapters.
- To effectively implement the ICD-10-CM code changes, practices should ensure role-based training, coordinate with their EHR vendor, communicate with payers, and monitor claim denials to maintain coding and billing compliance.
Editor's note: This article was updated on October 1, 2024.
In July 2024, the Centers for Medicare & Medicaid Services (CMS) announced new, revised, and deleted ICD-10-CM medical codes for fiscal year (FY) 2025, giving medical practices just a few short months to prepare for the important changes that took effect on October 1, 2024.
While annual coding updates occur consistently, what’s less predictable is the answer to this question: What are the changes to the ICD-10 code system for 2025? In this blog, we provide a brief summary.
Why should physicians pay attention to the 2025 ICD-10 code changes?
Understanding the 2025 ICD-10 code changes helps physicians maintain coding and billing compliance. To ensure revenue integrity and avoid denials, providers must assign correct and specific ICD-10-CM diagnosis codes. That’s in addition to their CPT or HCPCS procedures codes. Nonspecific or invalid diagnosis codes can cause denials.
What are the new ICD-10-CM codes for FY 2025?
Here’s a chapter-by-chapter breakdown of ICD-10 code changes for 2025:
- Chapter 2 (neoplasms): Includes new lymphoma codes to identify "in remission."
- Chapter 3 (diseases of the blood and blood-forming organs): Includes one new code for Fanconi anemia.
- Chapter 4 (endocrine, nutritional, and metabolic diseases): Includes new codes for presymptomatic type 1 diabetes mellitus, hypoglycemia levels, carcinoid syndrome obesity class, and others.
- Chapter 5 (mental, behavioral, and neurodevelopmental disorders:) Includes new codes for anorexia, bulimia, and binge-eating disorders.
- Chapter 6 (diseases of the nervous system): Includes new codes for KCNQ2, serotonin syndrome, other disorders of the autonomic nervous system, and developmental and epileptic encephalopathy.
- Chapter 9 (diseases of the circulatory system): Includes new codes for cement or fat embolism of pulmonary artery.
- Chapter 10 (diseases of the respiratory system): Includes new codes for nasal valve collapse.
- Chapter 11 (diseases of the digestive system): Includes new codes for anal fistula.
- Chapter 12 (diseases of the skin and subcutaneous tissue): Includes new codes for cholestatic pruritus and alopecia.
- Chapter 13 (diseases of the musculoskeletal system and connective tissue): Includes new codes for discogenic low back pain, multifidus muscle dysfunction, synovitis, and tenosynovitis.
- Chapter 17 (congenital malformations, deformations, and chromosomal abnormalities): Includes new codes for congenital malformations of aortic and mitral valves.
- Chapter 18 (signs, symptoms, and abnormal findings): Includes one new code for anosognosia.
- Chapter 19 (injuries, poisonings, and external causes): Includes new codes for adverse effects of immune checkpoint inhibitor immunotherapy and disruption of gastrointestinal tract anastomosis.
- Chapter 21 (factors influencing health status and contact with health services): Includes new codes for social determinants of health, pediatric obesity body mass index, personal history of colon polyps, and more.
What are the deleted and revised ICD-10-CM codes for FY 2025?
With the 2025 ICD-10 code changes, several ICD-10-CM codes will be deleted; however, they will be replaced by new, more specific options.
“With the 2025 ICD-10 code changes, several ICD-10-CM codes will be deleted; however, they will be replaced by new, more specific options.”
Revised code changes are also relatively minor (e.g., removing the reference to bilateral "eye" in codes for degenerative myopia and adding the term "thrombotic" to codes for subsegmental pulmonary embolism).
What are some FAQs on the ICD-10 code changes for 2025?
Following are several FAQs about the ICD-10 2025 code changes:
Q: How many code changes are there for 2025?
A: ICD-10 code changes for 2025 include 252 additions, 36 deletions, and 13 revisions.
Q: Where can coders and others access the FY 2025 ICD-10-CM codes?
A: There are several ways to access the 2025 ICD-10-CM code changes:
- First, CMS provides several files on its FY 2025 ICD-10-CM website.
- Second, you can download the 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.
- Finally, you can use Tebra’s ICD-10-CM glossary that includes code descriptions, related codes, symptoms, instructional guidelines, and more.
Q: Which ICD-10-CM chapters have the most 2025 ICD-10-CM code changes?
A: Chapter 2 (neoplasms) has the most changes (i.e., 63 new codes). However, medical practices should pay close attention to the Chapter-specific changes most relevant to their specialties. For example, chiropractic practices should focus on chiropractic code changes 2025 in Chapter 13, while dermatology practices should focus on ICD-10 2025 code changes in Chapter 12.
“The 2025 ICD-10-CM code changes affect anyone who documents in the medical record, assigns medical codes, queries clinical information, or uses coded data regularly.”
Q: How do coders know what ICD-10-CM codes to report and when?
A: The ICD-10-CM Official Guidelines for Coding and Reporting provide specific details about when and how to report the codes. However, be sure to use the most up-to-date version for FY 2025. Access coding guidelines for 2025 here. Pay attention to narrative changes that appear in bold text.
What are some tips and strategies to implement the ICD-10-CM code changes for FY 2025?
Consider the following when implementing the ICD-10 2025 code changes:
- Ensure role-based training. The 2025 ICD-10-CM code changes affect anyone who documents in the medical record (e.g., physicians and other providers), assigns medical codes (e.g., medical coders), queries clinical information (e.g., clinical documentation specialists), or uses coded data regularly (e.g., practice managers, other revenue cycle management staff, and health information technology professionals). Role-based training is important because it helps ensure individuals can leverage new information to perform their jobs effectively. They receive the level of detail that’s necessary — no more, no less. Note: Don’t forget to provide training on coding guidelines for 2025.
- Talk with your electronic health record (EHR) vendor rep. Ensure your EHR vendor includes the changes in its software updates — particularly in EHR templates and practice management systems.
Explore Tebra’s cloud-based, ONC-certified electronic health record (EHR) with a free demo or product tour.
- Communicate with payers. It’s also important to check with your payers to learn about any coverage-related changes, including changes to prior authorizations, as well as any new diagnosis-related documentation requirements.
- Monitor claim denials. Keep a close eye on key performance indicators during the 4th quarter of 2024 and provide education and training when necessary.
Looking ahead to FY 2025 ICD-10-CM diagnosis codes
Now that the October 1, 2024 implementation deadline for the FY 2025 ICD-10-CM diagnosis codes is here, medical practices who make sure to train coders, physicians, and others on these changes will help them ensure clean claims and smooth cash flow.
To learn more about the ICD-10-CM changes for FY 2025, visit Tebra’s library of ICD-10-CM codes. Also, be sure to visit the Tebra website to learn more about how Tebra’s medical billing solution can help improve the financial health of your medical practice.
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