The ICD-10-CM code set update for Fiscal Year (FY) 2027 has been officially released on the Centers for Medicare & Medicaid Services (CMS) website. The annual ICD-10-CM 2027 Update introduces a total of 238 new codes, revises four existing codes, and removes 21 codes from the system. These changes are set to take effect on October 1, 2026. Below is a detailed overview of some of the most significant changes you can expect.
Neoplasm and Blood Disease Coding Updates
- Secondary malignant neoplasm coding will see increased specificity in FY 2027. The codes C78.- (Secondary malignant neoplasm of respiratory and digestive organs) and C79.- (Secondary malignant neoplasm of other and unspecified sites) are being expanded with three new codes. These additions are designed to allow for more precise identification of the anatomical sites of metastatic cancers.
- Within the D50-D89 category (Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism), a meaningful enhancement has been made. The inclusion terms for D69.1 (Qualitative platelet defects) are being deleted and reorganized into two new codes:
- 11: Glanzmann thrombasthenia, which now encompasses Glanzmann’s disease as well as hemorrhagic and hereditary thrombasthenia.
- 19: Other qualitative platelet defects, now including Bernard-Soulier (giant platelet) syndrome, grey platelet syndrome, and thrombocytopathy.
- Another significant oncology-related update involves D05.- (Carcinoma in situ of breast) codes. Previously, it was possible to report a code from C50.- (Malignant neoplasm of breast) together with a code from D05.- when both conditions were diagnosed in a patient. Starting October 1, simultaneous reporting of these two codes for the same patient will no longer be permitted.
Postprocedural Blood Sugar Coding
- Three new codes are being introduced for documenting low blood sugar levels following surgery:
- 83: Postprocedural hypoglycemia following a procedure
- 830: Post bariatric hypoglycemia
- 838: Other postprocedural hypoglycemia
Cardiac Coding Changes
- The codes for dilated cardiomyopathy are being made more specific. The existing code I42.0 will be subdivided into:
- 00: Dilated cardiomyopathy, unspecified
- 01: Familial-genetic dilated cardiomyopathy
- 09: Other dilated cardiomyopathy
Odontogenic Sinusitis
- New codes for odontogenic sinusitis are added under the subcategory J34.83-. These will require use of a sixth character to specify the affected sinus—whether it is maxillary, ethmoid, frontal, or sphenoid.
New K Codes (Gastrointestinal and Liver Updates)
- B: Hypertrophic pyloric stenosis, in childhood, is being added.
- -: Diseases of the pelvis, not elsewhere classified, will be a new code category.
- For reporting hepatic fibrosis, the ICD-10-CM 2027 Update introduces K74.0A: Hepatic fibrosis, moderate fibrosis, which is to be used for conditions or diagnoses classified as stage F2 hepatic fibrosis.
Skin Condition Codes
- 237: Carbuncle of flank is a newly added code.
- Three existing codes are being revised for more clarity:
- 232: Carbuncle of back (any part except buttock and flank)
- 312: Cellulitis of back (any part except buttock and flank)
- 322: Acute lymphangitis of back (any part except buttock and flank)
Plantar Fasciitis and Fibromatosis
- The new M67.A- subcategory addresses plantar fasciitis and includes codes for plantar fascial fibromatosis diagnoses.
Osteomyelitis Coding
- Several new codes are being introduced in the M86.8X- category for “other osteomyelitis.” Reporting will now require a seventh character to specify whether the affected anatomical structure is unspecified or located on the right or left side of the body.
- A new code is also being added for VEXAS syndrome, a severe autoinflammatory disorder that typically arises in adulthood and involves the immune system attacking the body’s own tissues.
N & O Category Code ICD-10-CM 2027 Updates
- The N99.86- subcategory is added for “intraoperative and postprocedural complications and disorders of breast.”
- There are 56 new codes for different types of ectopic pregnancies.
- A new category, O31.4-, is introduced for “continuing pregnancy after vanishing twin syndrome of one fetus or more,” with multiple new codes included.
Q Codes for Congenital Malformations
- New codes are being introduced for congenital malformations, covering conditions such as Loeys-Dietz syndrome, Lynch syndrome, and Li Fraumeni syndrome.
Atypical Gadolinium Levels
- A new code, R78.72, is added under the R78.7- subcategory (Finding of abnormal level of heavy metals in blood) to specifically capture abnormal gadolinium level in blood.
Sternoclavicular Sprain
- The code S23.420- (Sprain of sternoclavicular [joint] [ligament]) will be deleted for FY 2027.
Toxic Effects
- The T52.81- code marks the start of several additions for documenting the toxic effects of alkenes and related substances.
Z Code Revisions: Enhanced Specificity and Sensitivity
- The proposed changes for Z codes in 2027 are varied. Some codes will remain the same, some descriptions are being refined, and some broad categories are being split into more specific, reportable options.
- Notably, the ICD-10-CM 2027 Update increases the specificity and sensitivity in reporting changes to patients’ sex and gender, allowing for more accurate and respectful health records.
Source: FY 2027 ICD-10-CM Updates