The ICD-10 updates 2025 bring significant advancements to align healthcare reporting with  modern technologies like AI in medical coding. These medical coding updates 2025 include new, revised, and deleted codes that reflect emerging medical conditions, procedures, and treatments. By integrating automated coding software, healthcare organizations can manage ICD-10 documentation. More efficiently and use revenue cycle management AI to ensure better reimbursement accuracy.

New, revised, and deleted codes for ICD-10 Updates 

These updates include new medical conditions, procedures, and treatments. Which introduced under the ICD-10 updates 2025 and medical coding updates 2025.

ICD-10-CM codes (Effective October 1, 2025)

These ICD-10 new codes 2025 impact diagnosis reporting and are used for all patient encounters. 

• Diseases of the Skin (Chapter 12): This chapter saw the highest number of new codes, with a significant expansion for non-pressure chronic ulcers (non-pressure ulcer ICD-10.
  • New L98.A- codes: Introduce more specific reporting for non-pressure chronic ulcers of the upper limb (e.g., forearm, hand).
  • Revised Flank Codes: Add more specific codes for the flank area for conditions like cellulitis and abscesses, which were previously reported using abdominal codes.

• Toxic Effects (Chapter 19): Reflects emerging public health issues. It also strengthens ICD-10 documentation requirements to ensure higher coding accuracy.

• New Xylazine Codes: New codes were created to report the toxic effect of the drug xylazine (T66.84-) and associated skin ulcers, an issue identified by public health officials.

Mental, Behavioural, and Neurodevelopmental Disorders (Chapter 5):

• New Eating Disorder Codes: Add more detailed eating disorder ICD-10 codes for anorexia nervosa, bulimia nervosa, and binge eating disorder, allowing for reporting of both severity (mild to extreme) and remission.
• Neurodevelopmental Disorders: Enhanced classification for neurodevelopmental disorder ICD-10 ensures better reporting accuracy.

Eye and Adnexa (Chapter 7):

• New Demodex Mite Codes: added New Demodex blepharitis ICD-10 cods for (eyelid inflammation caused by mites) and improved specificity for inflammation of the eyelid (H01.8-) based on which eye is affected.

Genetic Disorders (Chapter 17):

• New QA0- Category: Created for reporting neurodevelopmental disorders associated with specific genetic variants (neurodevelopmental disorder ICD-10).

 

Deleted Codes: Several codes were deleted and replaced with more specific ones. For example, the general pelvic and perineal pain code R10.2 now has multiple new codes that specify location and laterality.

Overall, the ICD-10 updates 2025 improve diagnostic precision while supporting AI medical coding services and automated coding software used for compliance and claim optimization.

HCPCS Level II codes (Effective October 1, 2025) 

The ICD-10 updates 2025 and medical coding updates 2025 also include essential changes to HCPCS Level II codes, which introduce new entries for drugs, devices, and durable medical equipment. These updates strengthen ICD-10 documentation requirements and work in tandem with AI in medical coding systems for real-time data validation and improved revenue cycle management AI.

• New J-Codes: Added for new and newly available drugs that improve treatment outcomes and documentation accuracy under the ICD-10-CM 2026 updates.
  • J0458: Injection, aztreonam/avibactam for complicated intra-abdominal infections.
  • J0738 (Injectable) and J0752 (Oral): For the HIV pre-exposure prophylaxis (PrEP) drug, lenacapavir.

With the help of automated coding software, these codes can be implemented accurately across electronic health record systems, ensuring consistent claim submission and compliance with medical coding updates 2025.

• New Q-Codes: Added for newly released biosimilar drugs.
  •   Q5155: Injection, aflibercept-jbvf (Yesafili), biosimilar.

• New E-Codes: For certain durable medical equipment, like a segmental pneumatic appliance (E0658).

These enhancements simplify device and drug coding across specialties. Using AI in medical coding helps organizations adopt codes faster and stay compliant with ICD-10 updates 2025 and ICD-10 documentation requirements without manual delays.

In combination with revenue cycle management AI, the HCPCS Level II updates enhance payment accuracy, reduce denials, and improve claim traceability — making it a key focus of medical coding updates 2025 and ICD-10-CM 2026 updates.

Guideline revisions: ICD-10-CM Guideline Revisions (FY 2026)

The ICD-10-CM 2026 updates bring crucial guideline revisions that improve documentation, accuracy, and sequencing of diagnoses. These changes are part of the broader medical coding updates 2025, ensuring compliance and better integration with AI in medical coding and automated coding software for enhanced precision in reporting.

Section I: Conventions and General Coding Guidelines

• Multiple Sites (New Guideline I.B.20): New guidance clarifies how to code for conditions affecting multiple anatomical sites. If a chapter has specific guidance for multiple sites, follow that. Otherwise, code each site individually if documented, or use a “multiple sites” code if specified.
• Documentation by Non-Providers (Guideline I.B.14): Clarification was made regarding documentation by non-physician providers, such as nurses and other clinicians — improving compatibility with automated coding software and AI in medical coding systems.

AI in medical coding tools can instantly verify such documentation, helping maintain ICD-10-CM 2026 compliance and minimizing claim errors.

Section II: Guidelines for Selection of Principal Diagnosis

• HIV disease (Guideline I.C.1): Revisions were made to the sequencing and assignment of HIV codes, particularly when HIV-related conditions or comorbidities are present. This includes guidance on when to use code B20 (HIV disease) versus Z21 (asymptomatic HIV infection status). 
• AI in medical coding helps coders identify such sequence patterns quickly, reducing rework and enhancing the efficiency of automated coding software.

Section III: Reporting Additional Diagnoses

• Diabetes mellitus in remission (New Guideline I.C.4.a.1.b): A new guideline covers code E11.A (Type 2 diabetes mellitus without complications in remission). This update improves coding precision and directly supports ICD-10 new codes 2025 and ICD-10-CM 2026 updates.
• Hypertension with CKD and Heart Disease (Guideline I.C.9.a.3): Updated sequencing guidance provides improved clarity for using combination codes (Category I13) that include hypertension, heart disease, and chronic kidney disease ICD-10, which benefits claim accuracy and revenue cycle management AI.

• Categories of Z Codes (Guideline I.C.21): Guidelines for certain Z codes related to status, aftercare, and social determinants of health (SDoH) were revised.
• Body Mass Index (BMI) (Guideline I.C.21): Updated guidance indicates that BMI codes should be assigned only when an associated, reportable diagnosis (e.g., obesity or anorexia) is documented. For fluctuating BMI during an encounter, the most severe value should be assigned, ensuring accurate obesity classification ICD-10

Specificity requirements for ICD-10 Medical Coding Updates

Many medical coding updates 2025 focus on refining clinical precision and improving documentation quality. The latest ICD-10 updates 2025 and ICD-10-CM 2026 updates introduce greater specificity for conditions like presymptomatic diabetes ICD-10 and obesity classification ICD-10. These refinements are essential for compliance with ICD-10 documentation requirements and accurate claim management using AI in medical coding and revenue cycle management AI systems.

Specificity for presymptomatic Type 1 diabetes

Before these ICD-10 updates 2025 updates, presymptomatic Type 1 diabetes was typically coded with R73.03 (Prediabetes).

The new E10.A- codes now allow for a more precise diagnosis, enabling better tracking and early intervention, and improved outcomes through revenue cycle management AI and AI in medical coding integration.

The presymptomatic diabetes ICD-10 codes now include:

• A0: Type 1 diabetes mellitus, presymptomatic, unspecified.
• A1: Type 1 diabetes mellitus, presymptomatic, Stage 1. This stage is defined by multiple confirmed islet autoantibodies with normoglycemia (normal blood sugar).
• A2: Type 1 diabetes mellitus, presymptomatic, Stage 2. This stage is characterised by confirmed islet autoimmunity with dysglycemia (abnormal blood sugar)

The inclusion of presymptomatic diabetes ICD-10 helps providers document risk stages before full disease progression. When combined with automated coding software and AI in medical coding, these updates improve workflow accuracy and ensure smooth medical billing ICD-10 2025 compliance.

Specificity for obesity classifications

The new obesity classification ICD-10 for obesity classify a patient’s condition based on their Body Mass Index (BMI), adding more detail than previously available. The ICD-10 documentation requirements now ask coders to specify both BMI and the cause or impact of obesity. This approach improves reporting accuracy and ensures compliance with medical coding updates 2025.

Updated obesity classification ICD-10 codes include:

• E66.811: Obesity, class 1 (BMI 30.0–34.9).
• E66.812: Obesity, class 2 (BMI 35.0–39.9).
• E66.813: Obesity, class 3 (BMI 40.0 or greater).
• E88.82: Obesity due to disruption of the melanocortin-4 receptor (MC4R) pathway. This is a genetically based form of obesity that requires an additional code for associated manifestations, such as polyphagia (R63.2).
• Z15.2: Genetic susceptibility to obesity — applicable under obesity classification ICD-10 revisions.

By aligning with ICD-10 new codes 2025 and ICD-10-CM 2026 updates, these refinements support better tracking, improved reimbursement through revenue cycle management AI, and seamless integration into AI in medical coding systems. Such clarity ensures that payers receive precise data for claims, reducing denials and ensuring financial accuracy.