ICD-10 Updates for Fiscal Year 2025
For Fiscal Year (FY) 2025, CMS has released updated ICD-10-CM and ICD-10-PCS files. These updates are implemented in two phases throughout the fiscal year.
Initial 2025 Updates (October 1, 2024 – March 31, 2025)
The initial set of 2025 ICD-10-CM files are applicable for discharges and patient encounters occurring from October 1, 2024, to March 31, 2025. These files include essential resources such as:
- 2025 Code Descriptions in Tabular Order
- 2025 Addendum
- 2025 Code Tables, Tabular and Index
- FY 2025 ICD-10-CM Guidelines
It’s important to note that the 2025 POA Exempt Codes file and the 2025 Conversion Table remain unchanged from previous versions during this period.
Subsequent 2025 Updates (April 1, 2025 – September 30, 2025)
A second set of updates for FY 2025 ICD-10-CM and ICD-10-PCS are designed for discharges and patient encounters from April 1, 2025, to September 30, 2025. These files ensure that coding practices remain current throughout the latter half of the fiscal year.
ICD-10 Updates for Fiscal Year 2024
The updates for FY 2024 were also released incrementally, with an initial set for the majority of the fiscal year and a mid-year update.
2024 Updates – Initial Release
The first set of FY 2024 files were effective for discharges and patient encounters from October 1, 2023, to September 30, 2024. These updates ensured the ICD-10 systems were up-to-date for the main part of the fiscal year.
2024 Updates – April 1, 2024 Revision
An update on April 1, 2024, for ICD-10-CM addressed typographical errors within the code files. Critically, no new diagnosis codes were introduced at this time, focusing solely on corrections to existing documentation. For ICD-10-PCS, however, the April 1, 2024 update included the implementation of 41 new procedure codes. This expansion of procedure codes reflects the evolving landscape of medical treatments and interventions that need to be accurately captured within the coding system.
ICD-10 Updates for Fiscal Year 2023
FY 2023 saw significant additions to ICD-10-CM, particularly in the area of social determinants of health.
2023 Updates – Initial Release
The FY 2023 files were used from October 1, 2022, to September 30, 2023, for both discharges and patient encounters.
2023 Updates – April 1, 2023 Expansion
Effective April 1, 2023, the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) introduced 42 new diagnosis codes to ICD-10-CM. These codes were specifically designed to capture health-related social needs (HRSNs). HRSNs represent an individual’s unmet social needs that negatively impact their health outcomes. The introduction of these codes highlights the growing recognition of social factors as critical determinants of health and the need to incorporate them into medical diagnosis and reporting for a more holistic view of patient health. In ICD-10-PCS, 34 new procedure codes were implemented on April 1, 2023, further expanding the specificity of procedure coding.
ICD-10 Updates for Fiscal Year 2022
The public health emergency caused by COVID-19 heavily influenced the updates for FY 2022, with new codes introduced to track vaccination status and COVID-19 treatments.
2022 Updates – Initial Release
The FY 2022 files were in effect from October 1, 2021, to September 30, 2022.
2022 Updates – April 1, 2022 COVID-19 Response
In response to the COVID-19 pandemic, on April 1, 2022, the NCHS implemented 3 new diagnosis codes (Z28.310, Z28.311, and Z28.39) in ICD-10-CM to report COVID-19 vaccination status. This allowed for the systematic collection of data related to vaccination, crucial for public health monitoring and response. Concurrently, CMS introduced 9 new procedure codes in ICD-10-PCS to specifically code for the introduction or infusion of COVID-19 therapeutics, including vaccines. These new codes were essential for tracking and analyzing the utilization of COVID-19 treatments. Further expanding the procedure codes, an additional 2 new procedure codes were later added as errata.
ICD-10 Updates for Fiscal Year 2021
The initial stages of the COVID-19 pandemic also prompted updates in FY 2021 to capture diagnoses and treatments related to the virus.
2021 Updates – Initial Release
The FY 2021 ICD-10 files were applicable from October 1, 2020, to September 30, 2021.
2021 Updates – January 1, 2021 COVID-19 Emergency Response
Effective January 1, 2021, NCHS implemented 6 new diagnosis codes in ICD-10-CM in response to the ongoing COVID-19 public health emergency. These new codes provided greater specificity in diagnosing conditions related to COVID-19. Similarly, CMS implemented 21 new procedure codes in ICD-10-PCS on January 1, 2021, to code for the administration of COVID-19 therapeutics.
Conclusion
Staying current with CMS diagnosis coding updates is essential for accurate healthcare data management, billing, and reporting. The ICD-10-CM and PCS systems are continuously evolving to reflect advancements in medical knowledge, public health needs, and the complexities of healthcare delivery. Regularly reviewing updates from CMS and understanding their implications is a critical practice for all professionals involved in medical coding and healthcare administration.
Note regarding GEMs Files: For FY 2021, 2022, and 2023, there were no GEMs (General Equivalence Mappings) files released. As per the FY 2016 IPPS/LTCH PPS final rule, GEMs updates have been integrated into the annual ICD-10 Coordination and Maintenance Committee meetings process and were planned to continue for approximately 3 years post-ICD-10 implementation.
