The release of the Fiscal Year (FY) 2025 ICD-10-CM code updates brings a fresh set of changes for healthcare professionals, particularly for medical billers and billing companies. Starting October 1, 2024, these updates included new codes, revisions, and deletions that affect how diagnoses are documented and billed, making it crucial for your billing teams to stay informed about coding changes and adopt their implementation. We’ve put together this Medical Billers Guide to 2025 ICD-10-CM Codes to help you successfully incorporate important code changes at your medical billing practice.
While the number of new codes has decreased compared to previous years, getting up to speed with these changes still offers an important opportunity for billing companies to enhance the accuracy and specificity of their coding, which can lead to fewer denials and more streamlined operations. Let’s closely examine some key highlights and why these updates matter for your billing operations.
Overviewing the FY 2025 ICD-10-CM Code Updates
The 2025 updates include 252 new codes, 34 deletions, and 13 revisions. While this year sees fewer additions than FY 2024, the updates expand diagnosis coding granularity in several significant areas, such as lymphoma, diabetes, and eating disorders. Here’s a quick breakdown of the changes:
| Year | New Codes | Deleted Codes | Revised Codes |
| 2025 | 252 | 34 | 13 |
| 2024 | 395 | 25 | 13 |
Breaking Down the Code Updates by Chapter
Knowing your company’s billing specialties, you can examine the most pertinent code updates your team will encounter as they transition to using the new codes. Here’s a snapshot of how the updates affect different chapters in the ICD-10-CM codebook:
The comprehensive guidelines with specific codes can be found on the CMS website by clicking here to access the PDF. There is a table of contents starting on page 2 for you t0 reference specific specialties. You may also want to read about other changes affecting medical billers for 2025, such as those with the Medicare Advantage and Part D Payment and Policy Changes.
| ICD-10-CM Chapter | New Codes | Revised Codes | Invalid Codes |
| Chapter 1: Certain Parasitic and Infectious Diseases | 0 | 1 | 0 |
| Chapter 2: Neoplasms | 63 | 0 | 14 |
| Chapter 3: Diseases of the Blood and Blood-Forming Organs | 1 | 0 | 0 |
| Chapter 4: Endocrine, Nutritional, and Metabolic Diseases | 16 | 0 | 0 |
| Chapter 5: Mental, Behavioral and Neurodevelopmental Disorders | 26 | 1 | 4 |
| Chapter 6: Diseases of the Nervous System | 7 | 1 | 1 |
| Chapter 7: Diseases of the Eye and Adnexa | 0 | 5 | 0 |
| Chapter 8: Diseases of the Ear and Mastoid Process | 0 | 0 | 0 |
| Chapter 9: Diseases of the Circulatory System | 4 | 2 | 0 |
| Chapter 10: Diseases of the Respiratory System | 7 | 0 | 0 |
| Chapter 11: Diseases of the Digestive System | 27 | 1 | 3 |
| Chapter 12: Diseases of the Skin and Subcutaneous Tissue | 8 | 0 | 3 |
| Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue | 33 | 0 | 3 |
| Chapter 14: Diseases of the Genitourinary System | 0 | 0 | 0 |
| Chapter 15: Pregnancy, Childbirth, and the Puerperium | 0 | 0 | 0 |
| Chapter 16: Certain Conditions Originating in the Perinatal Period | 0 | 0 | 0 |
| Chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities | 4 | 1 | 1 |
| Chapter 18: Symptoms, Signs, and Abnormal Clinical and Laboratory Findings | 1 | 0 | 0 |
| Chapter 19: Injury, Poisoning, and Certain Other Consequences of External Causes | 30 | 0 | 3 |
| Chapter 20: External Causes of Morbidity | 0 | 0 | 0 |
| Chapter 21: Factors Influencing Health Status and Contact with Health Services | 25 | 1 | 2 |
| Chapter 22: Codes for Special Purposes | 0 | 0 | 0 |
Noting Significant Changes in the FY 2025 ICD-10-CM Updates
The FY 2025 ICD-10-CM updates introduce critical new codes and revisions that reflect the ongoing developments in medical documentation and healthcare, aiming to improve the specificity of diagnoses and make coding more accurate. Here are some key highlights from the update:
1. Expanded Lymphoma Codes
Sixty-three new codes have been added for lymphoma, focusing specifically on the ability to code for remission stages. This added precision will allow billing teams to differentiate between active disease and remission, improving the ability to track patient outcomes and enhance documentation for insurance claims.
2. Diabetes Coding Gets More Specific
Three new codes are introduced for presymptomatic Type 1 diabetes (E10.A-). These codes capture early-stage diagnoses, emphasizing the importance of early detection in managing this chronic condition. Billing for presymptomatic diabetes allows for more detailed claims related to preventive care and management.
3. Pulmonary Embolism Codes Now Include Fat and Cement Embolisms
New codes have been added to account for fat embolism (I26.03-I26.04) and cement embolism (I26.95-I26.96) of the pulmonary arteries, reflecting the need for more detailed descriptions in patients who experience these complications during specific medical procedures like surgeries and fractures. With these updates, billers can ensure claims include the exact type of embolism for more accurate reimbursement.
4. Obesity Classifications Updated
Four new codes have been added (E66.811-E66.89) to classify obesity into categories based on body mass index (BMI). These range from Class 1 (BMI 30-35) to Class 3 (BMI 40 or higher), providing an enhanced way to track and manage obesity, a condition that frequently leads to significant healthcare interventions and billing.
5. Eating Disorders Receive More Granular Classification
ICD-10-CM codes for eating disorders have been expanded to differentiate between the various severities of conditions like anorexia and bulimia (F50.010-F50.029). These updates allow for more specific billing codes based on severity (mild, moderate, severe, or extreme), ensuring claims better reflect the intensity of the treatment required.
6. Immune Checkpoint Inhibitor Coding for Adverse Effects
Eighteen new codes now track the adverse effects of immune checkpoint inhibitors, a cancer therapy gaining in popularity. These drugs, while highly effective, come with the risk of severe side effects that need accurate documentation for billing and treatment purposes. The new codes cover poisoning, adverse effects, and underdosing drugs such as Keytruda and OPDIVO.
7. New Personal History of Polyps Codes
Additional codes have been introduced to document the personal history of colon polyps (Z86.010- Z86.019) and distinguish between neoplastic and non-neoplastic polyps. This added specificity is crucial for tracking patients with a history of polyps, which can be risk factors for future colorectal issues.
8. KCNQ2-Related Epilepsy Codes
For children affected by KCNQ2-related epilepsy, four new codes (G40.43X-) now enable precise documentation of this genetic epilepsy syndrome, which allows for better treatment plans and tracking of outcomes. This level of detail in coding helps ensure accurate claims and supports more targeted interventions.
9. Congenital Heart Defect Updates
New codes for conditions such as bicuspid aortic valve (Q23.81) and congenital mitral valve abnormalities (Q23.82) now allow for detailed documentation of these common congenital heart defects. This enables better tracking of treatment plans and outcomes while helping insurance providers understand the complexities of these conditions.
10. Fanconi Anemia Now Has Its Own Code
A rare genetic disorder, Fanconi anemia (D61.03), now has a specific ICD-10-CM code, allowing better tracking and managing of this condition. Given its high malignancy risk, this update is significant for accurate documentation and reimbursement, as the condition is now classified as a complication and comorbidity (CC) under the new guidelines.
11. Nasal Valve Collapse Codes Introduced
Seven new codes (J34.82-) for nasal valve collapse differentiate between internal and external nasal valve collapse, as well as static versus dynamic collapses. This refinement will allow for better documentation of a condition affecting breathing, sleep quality, and overall quality of life, enhancing billing accuracy for treatments related to nasal valve issues.
Preparing Your Medical Billing Team for the FY 2025 ICD-10-CM Updates
The FY 2025 ICD-10-CM code updates bring new opportunities for medical billing companies to improve the accuracy of claims and reduce denials by using more specific and detailed codes. From expanded classifications to new codes, these updates require careful attention to ensure seamless integration into your billing operations.
To adopt these changes and maintain smooth workflows, it’s crucial to train your team, update your systems, and monitor claim outcomes closely. The more prepared your billing team is, the more efficiently you can handle the complexities of medical coding, which translates to faster payments, client satisfaction, and fewer headaches.
Is Your Team Ready for the 2025 ICD-10-CM Changes?
At 4D Global, we specialize in helping medical billing companies navigate complex code updates. Our expert team can support you with efficient, accurate revenue cycle management, ensuring compliance and streamlining your operations. Don’t let the new ICD-10-CM codes slow you down—partner with 4D Global to enhance your billing processes and maximize your efficiency.
Contact us today to see how we can help you manage these updates and keep your billing practices running smoothly. Let’s make sure you’re prepared for FY 2025 and beyond!