Get Ready for 2026 ICD-10-CM Updates Headed Your Way
Look to the new codes for more specificity on your urology claims. Get ahead of the curve with the 2026 ICD-10-CM codes, recently released by the Centers for Medicare & Medicaid Services (CMS). Dive into these updates and get comfortable with them before they become active on Oct. 1, 2025. Notably, these new codes bring significant updates for nephropathy and poisoning encounters. After reviewing the codes, try a few coding scenarios to check your understanding. Learn These New Genitourinary Codes Coders who frequent the N codes will want to take notice of two new subcategories. First up, N00.B- (Acute nephritic syndrome with immune complex membranoproliferative glomerulonephritis) features the following codes: Acute nephritic syndrome refers to an immune response activated by an infection or another condition. In the case of N00.B-, the response attacks the kidneys and damages the glomeruli, which filter waste from the blood in the kidneys. Sample coding scenario: A patient who has been recently diagnosed with strep throat sees the urologist complaining of blood in their urine and fatigue. After conducting a full physical examination and collecting a urine sample, the practitioner orders laboratory tests to confirm their findings. This diagnosis should be coded as N00.B2. Next, N04.B- (Nephrotic syndrome with immune complex membranoproliferative glomerulonephritis (IC-MPGN)) is designated for nephrotic syndrome conditions caused by immune complex membranoproliferative glomerulonephritis (IC-MPGN). Depending on the type of IC-MPGN, you’ll assign one of the following codes starting October 1: The last addition to the N codes is N07.B (Hereditary nephropathy, not elsewhere classified with APOL1-mediated kidney disease [AMKD]). You’ll also report this code when the physician diagnoses the patient with APOL1-mediated kidney disease (AMKD). AMKD may also occur with glomerulonephritis or glomerulosclerosis. You’ll assign N07.B for an AMKD diagnosis regardless of whether the physician makes a definitive diagnosis of AMKD with or without glomerulonephritis or with or without glomerulosclerosis. Watch for Updated Fluoroquinolone Adverse Effects Codes Healthcare providers can prescribe fluoroquinolone antibiotics to treat a wide array of infections, including pneumonia, sepsis, urinary tract infections (UTIs), and prostatitis. However, studies have shown that these drugs can cause rare, serious adverse effects. Physicians should exercise strong caution when prescribing fluoroquinolones to patients with risk factors for toxicity. The 2026 ICD-10-CM code book will add the T36.A- (Poisoning by, adverse effect of and underdosing of fluoroquinolone antibiotics) category. You will find the following codes listed: Each of these codes requires a 7th character to identify the type of encounter. Assign one of the following 7th characters to complete the codes: Sample coding scenario: A patient was prescribed a penicillin-based antibiotic for a UTI. After forgetting they already took a pill in the morning and taking more medication in a 24-hour period than they were prescribed, they began experiencing diarrhea, vomiting, and seizures. In this scenario, it would be appropriate to use code T36.AX5A (Adverse effect of fluoroquinolone antibiotics, initial encounter) for this encounter. Why would T36.AX1- be inappropriate for this encounter? It’s important to remember that T36.AX1- denotes an accidental poisoning, which normally refers to an external cause creating the reason the patient is seeking care, like an accidental overdose created by a medication error made by a healthcare professional. In the scenario above, the patient accidentally took more than the prescribed dose on their own, which is technically an intentional overdose, even though it was accidental on the patient’s end. Code T36.AX5- covers a wider range of scenarios, including the patient’s self-administered accidental overdose. Mike Shaughnessy, BA, CPC, Development Editor, & Lindsey Bush, BA, MA, CPC, Production Editor, AAPC
