FY 2025 ICD-10-CM code updates, guidelines released

From ACDIS News

In the last week, CMS released the fiscal Year (FY) 2025 ICD-10-CM code update and Official Guidelines for Coding and Reporting, which are effective October 1, 2024 through September 30, 2025.

The update includes new codes such as Z51.A, Encounter for sepsis aftercare, which will give coders the opportunity to report when providers warn patients and family members about sepsis risks, such as new or recurrent infections, and could provide the chance to rehabilitate new impairments, JustCoding reported.

The update includes three new codes to capture different levels of hypoglycemia, which were previously discussed during the September 2023 ICD-10-CM Coordination and Maintenance Committee meeting:

• E16.A1, Hypoglycemia level 1
• E16.A2, Hypoglycemia level 2
• E16.A3, Hypoglycemia level 3

The clinical classification levels, as explained in the September meeting, are:

• Level 1 is a glucose concentration less than 70 mg/dL and should be used as an “alert value” to help individuals avoid more severe hypoglycemia
• Level 2 is a glucose concentration less than 54 mg/dL and is the threshold at which neuroglycopenic symptoms begin to occur
• Level 3 is a severe event characterized by altered mental and/or physical functioning

The 2025 ICD-10-CM update also includes new codes to specify when lymphoma is in remission, such as C81.0A, Nodular lymphocyte predominant Hodgkin lymphoma, in remission.

Category M65.-, Synovitis and tenosynovitis, includes new codes to specify the location on the body. For example:

• M65.91-, Unspecified synovitis and tenosynovitis, shoulder
  • M65.911, Unspecified synovitis and tenosynovitis, right shoulder
  • M65.912, Unspecified synovitis and tenosynovitis, left shoulder
  • M65.919, Unspecified synovitis and tenosynovitis, unspecified shoulder   

CMS also released the 2025 ICD-10-CM Official Guidelines for Coding and Reporting, with updated language and examples.

In Chapter 2, Neoplasms, under Breast Implant Associated Anaplastic Large Cell Lymphoma, CMS updated the following (updated language in bold text):

Breast implant associated anaplastic large cell lymphoma (BIA-ALCL) is a type of lymphoma that can develop around breast implants. Assign code C84.7A, Anaplastic large cell lymphoma, ALK-negative, breast, for BIA-ALCL or C84.7B, Anaplastic large cell lymphoma, ALK-negative, in remission, for BIA-ALCL in remission. Do not assign a complication code from chapter 19.

CMS added a new guideline under types of diabetes (Chapter 4: Endocrine, Nutritional, and Metabolic Diseases), for pre-symptomatic Type 1 diabetes:  

1. Presymptomatic Type 1 Diabetes Mellitus Codes E10.A-, Type 1 diabetes mellitus, presymptomatic, are assigned for early-stage Type 1 diabetes that predates the onset of symptoms.

The new 2025 ICD-10-CM codes for pre-symptomatic Type 1 diabetes are:

• E10.A0, Type 1 diabetes mellitus, presymptomatic, unspecified
• E10.A1, Type 1 diabetes mellitus, presymptomatic, Stage 1
  • Stage 1 is described as multiple confirmed islet autoantibodies with normoglycemia in the 2025 ICD-10-CM Tabular Index.
• E10.A2, Type 1 diabetes mellitus, presymptomatic, Stage 2
  • Stage 2 is described as multiple confirmed islet autoimmunity with dysglycemia in the 2025 ICD-10-CM Tabular Index.

Editor’s note: To read the 2025 ICD-10-CM files, click here. This article originally appeared in JustCoding.