Get Familiar With the 2027 ICD-10-CM Updates
With nearly 300 coding changes, you won’t want to miss this. Our team has scoured the 2027 ICD-10-CM coding update — which included 238 new codes, four revised codes, and 21 deleted codes — to bring you a comprehensive list of everything you’ll need to know to be fully prepared for the changes coming your way on Oct. 1, 2026. Read on to keep your practice ahead of the curve. Take Note of These 3 Big Changes to Neoplasm and Blood Disease Reporting Secondary malignant coding will be more specific under ICD-10-CM 2027, as the C78.- ((Secondary malignant neoplasm of respiratory and digestive organs) and C79.- (Secondary malignant neoplasm of other and unspecified sites) codes have expanded. Currently, the Table of Neoplasms instructs you to report a secondary malignant neoplasm of the larynx, pharynx, or oral cavity with C78.39 (Secondary malignant neoplasm of other respiratory organs). However, beginning Oct. 1, 2026, you will have three new codes to pinpoint the anatomical sites of these metastatic cancers more precisely: There has also been a small but highly significant addition to the D50-D89 (Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism) codes. Code D69.1 (Qualitative platelet defects) sees all of its inclusion terms deleted and reallocated to two new codes: D69.11 (Glanzmann thrombasthenia) and D69.19 (Other qualitative platelet defects). Under D69.11, you will now find Glanzmann’s disease and both hemorrhagic and hereditary thrombasthenia, while Bernard-Soulier (giant platelet) syndrome, grey platelet syndrome, and thrombocytopathy will all be found under D69.19. The last big change in oncology coding occurs in the D05.- (Carcinoma in situ of breast) codes. Currently, ICD-10-CM allows you to report a code from C50.- (Malignant neoplasm of breast) with a code from D05.-, as C50.- is subject to an Excludes2 instruction under D05.-. However, effective Oct. 1, 2026, this will no longer be the case, as ICD-10-CM has changed the Excludes2 instruction to Excludes1. This means you will no longer report the two codes together if a patient is diagnosed with both conditions, and you will only report a C50.- code in those circumstances. Review New Postprocedural Blood Sugar Coding Three new codes will be introduced regarding low blood sugar levels following surgery: Catch These Cardiac Coding Changes The 2027 ICD-10-CM revisions offer more specific descriptions for various diagnoses. For example, I42.0 (Dilated cardiomyopathy) will expand to I42.00 (Dilated cardiomyopathy, unspecified), I42.01 (Familial-genetic dilated cardiomyopathy), and I42.09 (Other dilated cardiomyopathy). Additionally, conditions often reported today under I42.8 (Other cardiomyopathies) or I49.8 (Other specified cardiac arrhythmias) would have distinct reportable codes, including I42.81 (Arrhythmogenic cardiomyopathy), I47.22 (Catecholaminergic polymorphic ventricular tachycardia [CPVT]), I49.81 (Brugada syndrome), and I49.82 (Ventricular bigeminy). If the provider’s documentation doesn’t support any of these more specific codes, options like I42.89 (Other cardiomyopathies not elsewhere classified) and I49.89 (Other specified cardiac arrhythmias not elsewhere classified) remain available. Observe How to Code Odontogenic Sinusitis Diagnoses The ICD-10-CM code book adds odontogenic sinusitis diagnoses with the J34.83- (Odontogenic sinusitis) code subcategory. You’ll use a 6th character to identify which sinus is affected by the condition — maxillary, ethmoid, frontal, or sphenoid sinus. Use J34.839 (Odontogenic sinusitis, unspecified) for cases of the condition where the physician didn’t specify which sinus was affected. Key Into New K Codes ICD-10-CM will add K31.B (Hypertrophic pyloric stenosis, in childhood) to the 2027 code book. You’ll also see the addition of the K6A.- (Diseases of the pelvis, not elsewhere classified) to the code book. This new code category includes the following codes: Starting in October, you’ll use K74.0A (Hepatic fibrosis, moderate fibrosis) to report the condition or a stage F2 hepatic fibrosis diagnosis. Also, you’ll find K76.83 (Intestinal failure-associated liver disease). See These Changes in Skin Condition Codes There is one new code this year related to skin and subcutaneous tissue, L02.237 (Carbuncle of flank), and there are also three revisions: Plan for Plantar Fasciitis and Fibromatosis Code Additions The 2027 ICD-10-CM code book will add M67.A- (Plantar fasciitis) with the following codes: Use M67.A09 (Plantar fasciitis, unspecified foot) when the documentation does not specify which foot is affected. The code set will also add the following codes for plantar fascial fibromatosis diagnoses: Analyze the New Osteomyelitis Codes There will be several additions to the M86.8X- (Other osteomyelitis) codes. You will need to choose a 7th character to identify whether the affected anatomical structure is unspecified or is on the right or left side of the body. Also, you’ll also need a 7th character for M86.8X8- (Other osteomyelitis, other site) to identify which structure is affected, such as: Another new M code has been created for VEXAS syndrome, a serious autoinflammatory condition that typically begins in adulthood and is characterized by the immune system targeting the body’s own tissues, by adding code M04.3 (VEXAS Syndrome). Get to Know the New N&O Codes Starting October 1, you’ll find a new N99.86- (Intraoperative and postprocedural complications and disorders of breast) code subcategory, which includes the following codes: Ectopic pregnancy codes: In Chapter 15: Pregnancy, Childbirth, and the Puerperium, ICD-10-CM will add 56 new codes, including: Vanishing twin syndrome: The ICD-10-CM code book will also add the O31.4- (Continuing pregnancy after vanishing twin syndrome of one fetus or more) category in October. This will include the following new codes: Each of the codes listed above require a 7th character to identify the fetus for which the code applies. Look at Tracking Q Codes for Frequency of Use There are several new codes being added to the congenital malformation section as follows: Make note: The “A” is added to track the use and frequency of this code. Assign R78.72 for Atypical Gadolinium Levels The R78.7- (Finding of abnormal level of heavy metals in blood) code subcategory will see a new code on October 1. You’ll report R78.72 (Abnormal gadolinium level in blood) when a healthcare provider diagnoses the patient with the condition. Sternoclavicular Sprain Code Sidelined ICD-10-CM will delete S23.420- (Sprain of sternoclavicular (joint) (ligament)) in 2027, along with these codes that extend to the 7th character: New Codes Add to Toxic Effects Options There will also be several additions to the toxic effects codes, starting with T52.81- (Toxic effects of alkenes). You will have to choose a 6th and 7th character for T52.81-, as you will with most of the other toxic effects codes in ICD-10-CM. The 6th character will identify the intent of the toxic exposure — accidental, intentional self-harm, assault, etc. The 7th character will identify encounter type for the injury. The new toxic effect code subcategories for 2027 are: 1 deletion: With the addition of T52.89-, ICD-10-CM no longer needs one toxic effects subcategory: T52.8X- (Toxic effects of other organic solvents). ICD-10-CM is deleting the entire subcategory, from T52.8X- to T52.8X4S (Toxic effect of other organic solvents, undetermined, sequela). More Specificity Means More Sensitivity Compared with 2026, the proposed 2027 Z code revisions are mixed: Some codes remain unchanged, some descriptors are refined, and some broad categories are expanded into more specific reportable options. For example, Z29.14 (Encounter for prophylactic rabies immune globulin) has been revised, and Z77.013 (Contact with and (suspected) exposure to gadolinium) and Z86.17 (Personal history of Clostridioides difficile infection), as well as Z77.32 (Contact with and (suspected) exposure to burn pits in war theater) and Z77.40-Z77.49 (Contact with and (suspected) exposure to blast overpressure and related subcategories) are new options, with the latter descriptors adding “(suspected).” The body mass index (BMI) changes offer greater specificity. In 2026, Z68.1 (Body mass index [BMI] 19.9 or less, adult) captured the entire adult BMI range at or below 19.9 in a single code, but the new code set splits that range into Z68.18 (Body mass index [BMI] 18.4 or less, adult) and Z68.19 (Body mass index [BMI] 18.5-19.9, adult). In practice, this could allow coders to report low adult BMI with greater precision, instead of defaulting to one broad code for all adults with a BMI of 19.9 or less. The 2027 update also offers more specificity and greater sensitivity in reporting changes to patients’ sex and gender. Z87.8901 (Personal history of social gender transition) is now a parent code. New codes include: Revenue Cycle Insider Editorial Team
