Each year, ICD-10-CM and ICD-10-PCS are updated to reflect advances in clinical practice, new medical technologies, and the need for greater precision in reporting. For 2026, the updates are significant, with nearly 650 total code changes. Coders, CDI specialists, and providers will need to be ready ahead of the October 1, 2025 implementation date.
ICD-10-CM: What’s New?
- 487 new diagnosis codes
- 28 deleted codes
- 38 revised codes
Key Highlights
- Updated HIV Guidelines: Revised wording makes it easier to know when to assign B20 (HIV disease) versus Z21 (asymptomatic HIV status).
- Instructional Notes Revamped: Multiple Excludes1 notes are changing to Excludes2, along with new excludes notes, inclusion terms, and “use additional code” and “code also” notes.
- Diabetes in Remission: A new code and guideline recognize this important clinical condition.
- Emerging Conditions Recognized: New codes address cannabis hyperemesis syndrome, Gulf War illness, Fontan-related circulation, baked egg and milk allergy, hyperoxaluria, inflammatory breast cancer, and more.
- Expanded Specificity: Greater detail will be available for familial hypercholesterolemia, lipodystrophy, multiple sclerosis, thyroid eye disease, and non-pressure chronic ulcers.
- Flank Region Codes: Conditions affecting the flank will be reported directly, rather than defaulting to the abdominal region.
- History & Genetic Susceptibility: New codes for personal/family history of disease, exposures, and genetic susceptibility allow for more robust reporting.
For a deep dive into these changes, join us for our webinar: BREAKING NEWS: ICD-10-CM Code Updates for 2026.
ICD-10-PCS: Key Updates for 2026
- 156 new procedure codes
- 27 deleted codes
- 0 title revisions
Key Highlights
- New Technology Expansion: As in recent years, most additions appear here, reflecting rapid innovation in medicine.
- Reassignment of Procedures: Procedures such as cerebral embolic protection during TAVR are moving from temporary New Technology codes into permanent sections.
- Cricothyroidotomy Clarified: A new code and updated Index/Body Part Key resolve long-standing questions; this procedure is now classified to the larynx rather than trachea.
- Orthopedic Innovations: New codes support subscapularis-sparing shoulder arthroplasty and meniscus replacement using autologous or nonautologous tissues.
- Wound Vac Placement: After years of requests, there is finally a code for wound vac placement in the Physical Rehabilitation and Diagnostic Audiology section.
- Drug Administration Update: 21 deletions and 15 additions in the New Technology Introduction table (XW0).
Get the full PCS update details in our webinar: BREAKING NEWS: 2026 ICD-10-PCS Coding Update.
Why It Matters
These code changes impact more than just coders—they affect documentation practices, CDI initiatives, quality metrics, and reimbursement outcomes. Preparing early helps ensure a smooth transition and prevents costly errors.
Next Steps for Coders and CDI Specialists
- Review the updated guidelines, especially around HIV coding and instructional notes.
- Educate providers on new documentation requirements for emerging conditions and expanded specificity.
- Practice coding scenarios in advance to build confidence before October 1.
- Engage your teams in education and review sessions to stay aligned.
Looking for additional information on this topic?
Meet the Presenter: Kristi Pollard, RHIT, CCS, CPC, CIRCC
Kristi is the Director of Coding Quality & Education with more than 25 years of industry experience; she is responsible for the development of web-based, instructor-led, and webinar training materials; conducting training in ICD-10-CM/PCS and CPT; and performing DRG and APC audits. Kristi has an extensive background in coding education and consulting and is a national speaker and published writer on topics related to ICD-10 and CPT coding and code-based reimbursement. She has designed and developed training programs for inpatient and outpatient hospital-based coding, with a focus on vascular interventional radiology, interventional cardiology, orthopedics, and obstetrics.
Great summary.