What’s New in the ICD-10 Updates for 2026? (Quick Overview)
Total number of new, revised, and deleted codes
The ICD-10 update 2026 includes 487 new diagnosis codes, 38 revised codes, and 28 deleted codes. This diagnosis code update represents the official code set to be used for dates of service on or after October 1, 2025.
When the 2026 ICD-10 changes take effect
All changes in the ICD-10 update 2026 take effect on October 1, 2025. Claims with dates of service on or after that date must use the new code set. Systems, charge masters, and EHR code libraries must be updated before that date to avoid denials. Early preparation reduces across-the-board disruption.
Specialties most impacted (neurology, endocrinology, SDOH, injuries, external causes)
The icd 10 changes 2026 have the biggest impact on:
- Neurology – expanded Multiple Sclerosis subtyping and activity-status codes.
- Endocrinology – Type 2 Diabetes in remission and genetic lipid disorder updates.
- Social Determinants of Health (SDOH) – new Z-codes for utility insecurity, financial insecurity, and war exposure.
- Injury and external causes – new codes for fishing hook injuries, blast overpressure, sharp-object penetrations, and activity-based mechanisms.
These specialties should prioritize readiness for the new ICD-10 codes for 2026 because the volume and specificity of changes in these areas are high and will directly impact coding workflows.
Why Are ICD-10 Updates Important for 2026?
Impact on accurate diagnosis coding
The ICD-10 update 2026 increases specificity across many conditions. More specific diagnosis codes improve clinical clarity, enable more precise care plans, and strengthen data for quality measurement and population health. Coding at higher specificity reduces ambiguity and helps clinical teams track disease course and outcomes more effectively.
Effect on Medicare, Medicaid, and commercial payer reimbursement
Medicare, Medicaid, and commercial payers require the updated codes for claims processing. Using outdated or deleted icd 10 codes for 2026 after the effective date can lead to claim rejections, delayed payments, and increased administrative burden. Payers will accept only valid ICD-10-CM codes for dates of service on or after Oct 1, 2025.
Why coders and billers must update systems before Oct 1, 2025
Coders and billers must update EHRs, billing platforms, charge masters, and clearinghouse mappings before October 1, 2025. Early testing, staff training, and charge-master updates reduce revenue disruption and protect cash flow. Practices that wait risk a spike in denials, time-consuming rework, and slowed revenue cycle performance in October and November 2025.
What Are the Key Areas Impacted in the 2026 ICD-10 Changes?
This section breaks down the major clinical and operational implications so teams can prioritize what to address first.
Which Medical Specialties Should Prepare for Major Changes?
Prepare now if you work in: neurology, primary care, endocrinology, allergy/immunology, emergency medicine, orthopedics, wound care, and behavioral health.
- Primary care will frequently use new diabetes remission and SDOH codes.
- Neurology must adopt detailed MS subtype and activity codes.
- Allergy teams should be familiar with expanded food allergy and tolerance codes.
- Emergency and trauma clinicians will see new injury and external cause codes.
Specialties with high patient volume or frequent use of codes in the affected categories should be the top priority for training and crosswalk updates.
Why Documentation Must Improve for 2026 Codes
Many new codes require explicit language in clinician notes. Examples:
- For Type 2 diabetes remission, the note must include the word “remission.”
- For MS, the note must state the subtype and whether the disease is active.
- For SDOH codes, the record should state the specific social risk (for example, difficulty paying utilities).
- Update templates and intake forms to prompt clinicians for these specifics at the point of care. Without these changes, coders will need to query providers more frequently, which will increase their workload and potentially lead to denials.
New ICD-10 Codes for 2026 (487 New Additions)
Below, we expand on the major clusters of additions and explain how to apply them.
What Are the New Neurology Codes for Multiple Sclerosis?
Multiple Sclerosis coding sees one of the largest conceptual shifts. The prior umbrella G35 approach is replaced by an expanded set of codes that identify:
- RR-MS (Relapsing-Remitting Multiple Sclerosis)
- PP-MS Active (Primary Progressive Multiple Sclerosis, active)
- PP-MS Not Active (Primary Progressive, not active)
- SP-MS Active (Secondary Progressive, active)
- SP-MS Not Active (Secondary Progressive, not active)
- Unspecified MS
This change forces clinicians to document both the MS subtype and activity status to support correct coding. The aim is to improve the clinical capture of prognosis and therapy needs. For coders, a missing subtype or activity will often require a provider query. Expect this to be one of the highest-volume code transitions for neurology clinics and multidisciplinary teams.
What Are the New Endocrine & Metabolic Codes?
Key endocrine and metabolic changes include:
- E11.A – Type 2 Diabetes Mellitus in remission. This code is for patients officially documented as in remission; the provider must state “remission” in the chart. The clinical criteria for remission will be determined by clinical practice, and coders should rely on explicit provider documentation rather than relying solely on lab values.
- Updated heterozygous familial hypercholesterolemia codes and more granular genetic lipid disorder entries.
- Additional rare metabolic disorder identifiers and clarified sequencing guidance for comorbid endocrine conditions.
These endocrine updates allow longitudinal tracking of remission, post-intervention outcomes, and genetic metabolic conditions for registries and quality programs.
Which New Social Determinants of Health (SDOH) Codes Were Added?
The diagnosis codes update expands SDOH granularity:
- Utility insecurity and several financial insecurity subcodes (for example, a code specific to difficulty paying utilities).
- War exposure and military-theater exposure codes to capture veteran and service-related risks.
- Expanded food allergy and tolerance status codes that distinguish between reactivity and tolerance to specific foods.
These SDOH codes help payers and care teams capture social risk more consistently, enabling better care coordination and more accurate risk adjustment. Z59.861 and related new codes are examples of this new emphasis on social risk detail.
What New Injury & External Cause Codes Were Introduced?
The update expands injury and external cause coding to capture:
- Fishing hook injuries and other specific mechanisms.
- Blast overpressure exposure and other military operation-related injuries.
- Sharp object penetrations and activity-based mechanism codes that specify what the patient was doing at the time of injury.
- Expanded S-codes for flank and abdominal wall injuries and contusions, with laterality.
This level of detail supports public health surveillance, occupational analysis, and more precise reporting of injury severity and mechanism.
What New Symptoms & Body Area Codes Are Added?
New localized symptom codes include:
- Abdominal wall tenderness entries and related symptom codes.
- Flank pain and flank injury codes with laterality.
These symptom codes align with the new injury and body-area codes, allowing for precise documentation and billing.
Revised ICD-10 Codes for 2026 (38 Updated Codes)
Thirty-eight codes had their descriptions or guidelines revised. Here is what to expect and how to act.
Which MS Codes Are Removed or Reclassified?
The prior single G35 MS code has been restructured into the new subtype and activity-status codes. This reclassification requires immediate education for providers and the development of coder crosswalks. If documentation lacks a subtype, a codable unspecified MS entry remains available; however, providers should be queried whenever possible for the most specific information.
What Changes Were Made to Endocrine & Metabolic Disorders?
Guidance now clarifies when E11.A (Type 2 diabetes in remission) is appropriate and how it sequences with other diabetes codes. The rules emphasize provider documentation of remission status rather than relying solely on lab results.
Which SDOH Categories Received Updated Descriptions?
Financial insecurity and food allergy categories were split into more specific subcodes. The revisions aim to enhance SDOH’s capture of actionable information and support effective care coordination.
What Wording Changes Affect Recordkeeping or Documentation?
Several code titles and notes were refined to add laterality and clearer inclusion/exclusion instructions. Wording changes can affect how coders search for codes in the index, so update your search guidance and internal code lists accordingly.
Deleted ICD-10 Codes for 2026 (28 Removals)
Deleted codes were generally removed because they were too broad. Here is what to do when you encounter a deleted code.
Which MS (G35) Codes Are Fully Deleted?
The prior umbrella MS code is deleted and replaced by the new MS subtype codes. Use the new subtype and activity codes for all encounters dated Oct 1, 2025, and later.
Why Are Some Injury & External Cause Codes Being Removed?
Broad, unspecified injury codes were removed to encourage the use of newly added, more precise alternatives that capture mechanism, site, and laterality. This improves data quality, but it requires clinicians to document specific details.
How to Replace Deleted Codes With 2026 Alternatives
- Build internal crosswalks mapping deleted codes to replacement codes.
- Update charge-master mappings and code selection picklists in the EHR so staff pick the correct new ICD-10 codes for 2026 automatically.
- Train coders on the most common deleted-to-new transitions that affect your specialty.
How Should Coders Document Newly Added Conditions in 2026?
Documentation drives coding. Here are specific documentation rules and sample language to use.
What Documentation Is Required for MS Subtypes + Activity Status?
- Minimum note elements: MS subtype, whether disease is active or not, and relevant clinical evidence (for example, recent relapse, MRI activity, or clinician impression).
- Example chart language: “Relapsing-remitting MS, active with clinical relapse on 09/12/2025” or “Secondary progressive MS, not active as of last visit.”
If the subtype is not known, document “MS, unspecified” and flag for clinician follow-up.
What Documentation Supports Diabetes “Remission”?
- Must include the word remission in the clinician’s note. Example: “Type 2 diabetes in remission since July 2024, no hypoglycemic agents, A1c 5.9%.”
- If the clinician documents only “controlled” or “resolved,” query the clinician for the specific term “remission” if that is the intended status. Coders should not assign E11.A without explicit documentation.
How Should Providers Document SDOH Screening?
Add a structured SDOH screening section in the history or social work note and capture:
- Utility insecurity: e.g., “Patient reports difficulty paying for utilities in the past 3 months.”
- Food allergies: specify the allergen, reaction type, tolerance status, and testing results or oral challenge outcomes.
- War exposure: record deployment details, exposure type, and relevant symptoms.
Structured SDOH data helps downstream teams and supports accurate Z-code assignment.
What Notes Are Needed for Injury & External Cause Codes?
Document the mechanism, activity, body site, laterality, and context. Example: “Fishing hook penetration to left thumb while cleaning fish; removed in ED; tetanus status documented.” These details allow coders to assign the correct S- and external cause codes.
What Do the 2026 ICD-10 Changes Mean for Medical Billing?
How New Codes Affect Reimbursement?
More granular diagnosis codes enhance risk adjustment, improve clinical documentation integrity, and facilitate the justification of complex care. Accurate use of new codes supports appropriate reimbursement and reduces downstream payer audits when documentation supports medical necessity.
Why Claim Denials May Increase in Oct–Nov 2025?
Denial risk is highest immediately after the effective date because:
- Practices may still use deleted or outdated codes.
- Clinician notes may lack the new specific language needed to support the more granular codes.
- Payer systems and clearinghouses may need time to fully accept and display the new codes.
Expect a short-term spike in claim rejections and an increase in coding queries unless you prepare proactively.
How Billing Teams Should Prepare Now
- Update systems: Ensure EHRs, billing, clearinghouses, and practice management systems are loaded with FY2026 code updates.
- Update charge master: map replaced codes with the new entries.
- Train staff to run focused sessions on high-impact codes, including MS, E11.A, SDOH, and injury codes.
- Test claims: Submit test claims through your clearinghouse to major payers where possible.
- Audit and monitor: Conduct pre- and post-implementation audits, and closely monitor denial trends.
How to Prepare Your Practice or Coding Team for ICD-10 2026
This checklist turns the guidance above into action items for implementation.
System & Software Updates Needed Before October 1, 2025
- Confirm vendors have loaded the FY2026 update.
- Verify pick-lists and diagnosis autocomplete reflect new codes and that deleted codes are removed.
- Test the practice’s billing flow end-to-end with new diagnosis codes.
How to Train Staff on New MS, Diabetes, Injury, and SDOH Codes
- Create 30- to 60-minute micro-training sessions for each impacted specialty.
- Provide quick reference cards that map common clinical phrases to new codes.
- Use case studies for hands-on practice, e.g., recode five recent charts using FY2026 rules.
How to Update EHR Templates & Documentation Fields
- Add structured fields for MS subtype, disease activity, diabetes remission, SDOH screening results, injury mechanism, and laterality.
- Implement required fields where practical, so clinicians are prompted to capture the new details at the point of care.
How to Run Internal Audits to Avoid Denials
- Re-code a representative sample of recent charts with the FY2026 set to identify documentation gaps.
- After going live, audit the first 200 claims for errors or denials and address systemic issues promptly.
Full List of 2026 ICD-10 Changes (New, Revised, Deleted Codes)
Full New Code List Summary
The new icd 10 codes for 2026 include 487 additions across neurology, endocrine, injury, SDOH, allergy, symptom codes, and more. Prioritize lists most relevant to your specialty for training and charge-master updates.
Full Revised Code Summary
Thirty-eight codes received wording updates or guideline revisions. Most changes clarify laterality, site, and sequencing. Review the tabular and index addenda for your practice’s top-used codes.
Full Deleted Code Summary
Twenty-eight codes were retired and replaced by more specific alternatives. Build crosswalks and update internal reference lists during the transition.
For authoritative downloads and the full tabular addendum, use the official CMS ICD-10 resources and the FY2026 coding guidelines available on the CMS and related coding organization websites.
Why the 2026 ICD-10 Changes Matter Now
- Greater specificity improves clinical accuracy and data quality. The new codes enable clinicians to capture disease state, activity, and social risk with greater precision.
- Using the correct codes prevents denials and payer rejections. Claims for dates of service on or after October 1, 2025, must use the updated code set.
- Updating systems and training staff ensures compliance with CMS requirements for the new ICD-10 update 2026.
- Clear documentation enables providers to accurately capture the correct diagnosis codes, which in turn supports accurate reimbursement.
- The new codes enable more accurate population health and social risk analytics. Use the update to refine registries, chronic care programs, and outreach.
Act now to update your systems, train staff, and revise documentation templates so your practice benefits from the new ICD-10 changes in 2026, rather than being disrupted by them.
Frequently Asked Questions
When do the ICD-10 updates 2026 officially take effect?
The ICD-10 update 2026 officially takes effect on October 1, 2025. Claims with dates of service on or after that date must use the updated codes.
How many new ICD-10 codes were added in total for 2026?
There are 487 new ICD-10 codes for 2026, plus 38 revised codes and 28 deleted codes.
Which specialties are most impacted by the new 2026 ICD-10 changes?
Neurology, endocrinology, primary care, emergency medicine, orthopedics, allergy and immunology, wound care, and behavioral health are among the specialties most significantly affected. Focus training on MS, diabetes remission, SDOH screening, and injury coding.
What documentation is needed for the new MS code categories?
Clinicians must document the MS subtype and whether the condition is active. Example: “Relapsing-remitting MS, active.” If either is missing, a coder should query the provider.
What is the new ICD-10 code for Type 2 Diabetes in remission?
The new ICD-10 code for Type 2 Diabetes in remission is E11.A. Assign this code only when the provider explicitly documents “remission.”
Which ICD-10 codes were deleted for 2026?
Twenty-eight codes were deleted, including broader umbrella entries that were replaced by more specific codes. Notably, the older general MS code was restructured into the new subtype codes.
How do the 2026 ICD-10 updates affect medical billing and reimbursement?
They require greater specificity to support claims and risk adjustment. Accurate coding supports better reimbursement and reduces denials; however, missing documentation or failure to update systems can lead to increased denials.
What new SDOH (Social Determinants of Health) codes were added?
New SDOH codes include entries for utility insecurity, more granular financial insecurity codes, war exposure, and expanded food allergy and tolerance classification.
How can practices prepare for the 2026 implementation of ICD-10?
Update systems, train staff on high-impact codes, revise EHR templates, run internal audits, and test claims and clearinghouse connectivity prior to October 1, 2025.
Where can coders download the full ICD-10 2026 update list?
Coders can download the full FY2026 ICD-10-CM addenda and coding guidelines from official CMS and CDC ICD-10 resources, as well as from major coding organizations and vendor portals.
