As the calendar flips to August, can you feel the shift in the air? Mums arrive at local garden centers, fall décor fills department stores, and pumpkin spice begins making its annual return. For coders, it also signals something else: time to prepare for the FY 2027 ICD-10 updates, effective October 1, 2026.

This year brings 190 new ICD-10-CM diagnosis codes, 30 deletions, and four revised code titles. On the procedure side, ICD-10-PCS has 101 new codes, three revised code titles, and 38 deleted codes.

That’s a lot to unpack – and preparing means much more than memorizing a list of codes or waiting for the encoder to be updated. Coders need to understand the clinical rationale behind the changes and what to look for in the documentation. After all, if you don’t know if a code exists for a specific condition or procedure, how can you code it?

What to Look Forward to with ICD-10-CM

The ICD-10-CM changes go well beyond new codes. Instructional notes have changed, including some of our familiar “musical Excludes notes,” where Excludes1 notes shift to Excludes2 and vice versa. New cross-references appear, and some sequencing instructions also change.

Then there are the new codes themselves, addressing conditions such as:

• Post bariatric hypoglycemia
• Cardiomyopathies and arrhythmias
• Odontogenic sinusitis and pulmonary mycetoma
• Hepatic fibrosis and intestinal failure-associated liver disease
• Lynch syndrome, hereditary cancer syndromes associated with BRCA1 and BRCA2, and Li-Fraumeni syndrome
• Low BMI
• Personal history of gender transition, detransition, and intersex surgery
• And much more

The lesson? Don’t rely on your encoder to do all the work. Understanding the conditions represented by these codes – and why greater specificity was needed – is an important part of applying them correctly.

ICD-10-PCS: New Technology Takes Center Stage

As has been the trend in recent years, much of the FY 2027 ICD-10-PCS activity centers on the New Technology section.

CMS reviewed New Technology Group 7 codes, originally implemented for FY 2022. Some technologies remain in Section X, some codes are deleted entirely, and others move into different sections of PCS as the technologies become more established.

FY 2027 also introduces two new tables:

• B85 – Other Imaging, allowing reporting of retinal and choroid fluorescein angiography
• XEZ – Other Procedures, a New Technology table that includes several software-as-a-medical-device technologies

Software as a medical device, or SaMD, is standalone software used for a medical purpose without being part of a hardware medical device. Several of the new codes involve artificial intelligence and other technologies designed to assist with clinical decision-making.

And we’ve barely scratched the surface of this year’s fall harvest of changes.

Learn the Change – and the Reason Behind It

Whether you code diagnoses, procedures, or both, FY 2027 reinforces an important lesson:

A new code is only useful when you understand when – and when not – to assign it.

That’s something an encoder can’t do for you.

If you’re looking for a deeper dive before October 1, Haugen Academy’s FY 2027 update webinars go beyond the code lists to explain the clinical context, documentation considerations, and coding rationale behind the changes.

ICD-10-CM FY 2027 Code Updates: What’s New, What’s Changed, and Why It Matters
Explore the diagnosis-code changes and what they mean for documentation, reporting, and real-world coding.

2027 ICD-10-PCS Coding Updates: Beyond the Tables and Into the Why
Review the procedure-code changes, revised guidance, New Technology updates, and documentation clues needed to identify new and revised PCS codes.

So, while you’re pulling out the fall decorations, watching the leaves begin to change, and deciding whether it’s too early for that first pumpkin spice latte, don’t forget one more item for your seasonal checklist: FY 2027 coding education.

October 1 will be here before we know it. Make sure you’re ready for more than the change in season.