FY 2026 ICD-10-CM Updates: 487 New Codes You Should Know
CMS added 487 new ICD-10-CM codes, deleted 28, and revised 38 effective October 1, 2025. Here is what independent practices need to update in their billing workflows.
The FY 2026 ICD-10-CM code set became effective October 1, 2025, and any encounter with a date of service on or after that date should already be using it. If you are reading this early in 2026 and your denials for unspecified or invalid diagnosis codes are creeping up, there is a good chance at least some of them trace back to the 487 new codes CMS added this cycle.
What Changed
CMS and the CDC's National Center for Health Statistics released the FY 2026 ICD-10-CM update on June 9, 2025, for discharges and encounters October 1, 2025 through September 30, 2026. The headline numbers:
| FY 2026 change | Count |
|---|---|
| New ICD-10-CM codes | 487 (part of 614 total new) |
| Deleted / invalidated codes | 28 |
| Revised codes | 38 |
| Term modifications | 88 |
| Billable status changes | 642 |
| New sections | 1 |
Notable specificity expansions in the update include:
- Multiple sclerosis — the single G35 code is being replaced with a family of codes adding meaningful clinical specificity.
- Pelvic and flank pain — new codes incorporating body site and severity.
- Non-pressure chronic ulcers — 129 new codes covering face, neck, hands, forearms, arms, chest, abdomen, and groin.
- Midsection contusions — greater specificity on anatomic location.
On the procedure side, FY 2026 ICD-10-PCS added 156 new codes and deleted 27, with four new tables. New procedures include vascularized nasal tissue transfer, cricothyroidotomy, subscapularis-sparing shoulder arthroplasty, meniscus replacement, and extracorporeal circulatory filtration. Inpatient coders should also note that CMS has announced a mid-year PCS update of 80 new codes effective April 1, 2026 — files are posted on the CMS ICD-10 page.
The updated FY 2026 ICD-10-CM Official Guidelines for Coding and Reporting were also published and took effect October 1, 2025.
Why It Matters
The 129 new non-pressure chronic ulcer codes and the expanded MS codes matter disproportionately for primary care, dermatology, wound care, neurology, and family medicine practices. Using a 2025 code for a condition that now requires one of the new, more specific FY 2026 codes typically results in:
- Automatic denials for "invalid code" if the old code was fully deleted.
- Denials for lack of specificity when a code's billable status changed.
- Downcoding from the payer when the diagnosis no longer supports the CPT level of service.
- HCC risk adjustment gaps for Medicare Advantage patients — specificity directly affects risk scores and capitation.
For small independent practices, the bigger operational question is whether the EHR and PM system picked up the October 1, 2025 update cleanly. Many vendors push the new code set automatically, but not all push the 642 billable status changes or the updated guidelines, and not all coders get a heads up when new codes become available in their most-used categories.
What to Do
- Run a denial report for dates of service October 1, 2025 onward, filtered to rejection reasons involving invalid or non-specific diagnosis codes. If the volume is elevated compared to prior months, you have a FY 2026 transition problem.
- Audit your top 25 diagnosis codes against the FY 2026 addendum. Specifically check whether any were deleted, revised, or had a billable status change. The CMS addendum file makes this a 30-minute exercise.
- Re-train coders on the expanded chronic ulcer and MS families if those conditions show up in your patient mix. These are two of the most commonly miscoded categories in the 2026 update.
- Confirm your EHR loaded the updated Official Guidelines, not just the code list. The guidelines drive sequencing, combination codes, and documentation rules that payer edits enforce.
- Plan for the April 1, 2026 PCS mid-year update if you bill inpatient procedures. Put a reminder on the calendar for early March to pull the files and update your chargemaster.
Talk to Us
If your denial rate jumped in Q4 2025 or Q1 2026 and you are not sure whether it is the ICD-10-CM transition, a payer policy shift, or something else, DeltaRCM can isolate the root cause in a focused audit and get you back to clean claims. Contact us for a coding and denials review.