What’s New in ICD-10 Updates for 2025

The 2025 ICD-10 updates bring vital changes for medical practices. For example, effective October 1, 2024, these updates add 252 new ICD-10-CM codes, delete 36, and revise 13. Additionally, new ICD-10-PCS codes improve procedure tracking. Accurate ICD-10 coding ensures successful billing. For instance, the 2025 updates add specificity to diagnoses and procedures. Moreover, they align with HIPAA standards and support value-based care. However, incorrect coding triggers claim denials. As a result, reimbursements delay and financial stability suffers. Therefore, Skyshine’s medical billing expertise streamlines coding. We help practices stay compliant and optimize revenue cycles. Consequently, our services reduce claim denials.

Major ICD-10-CM Changes for 2025

The 2025 ICD-10-CM update adds 252 codes, deletes 36, and revises 13, totaling 74,260 codes. Specifically, these changes enhance diagnostic clarity. Here are key highlights by chapter, based on CMS and CDC data:

Chapter Highlight

2: Neoplasms

• • • • 63 New Codes: For instance, codes like C81.0A-C81.9A track lymphoma “in remission.”

      • Impact: These codes improve cancer care billing. Skyshine audits EOBs to align ICD-10 with CPT codes, minimizing denials.

4: Endocrine, Nutritional, and Metabolic Diseases

• • • • New Codes: Codes like E10.A- (presymptomatic type 1 diabetes) and E16.A1-A3 (hypoglycemia levels) add detail.

      • Example: For example, E88.82 targets obesity due to MC4R pathway disruption.

      • Impact: These support chronic condition documentation. Skyshine ensures accuracy to prevent claim rejections.

5: Mental, Behavioral, and Neurodevelopmental Disorders

• • • • New Codes: Codes for anorexia (F50.010-F50.029) specify severity based on BMI.

      • Impact: Consequently, billing for eating disorders gains clarity. Skyshine trains staff to apply these codes correctly.

21: Factors Influencing Health Status

• • • • New Codes: For example, Z59.71 (insufficient insurance) and Z15.1 (epilepsy susceptibility) capture health factors.

      • Impact: These support value-based care. Skyshine integrates them into claims for better billing.

ICD-10-PCS Updates for 2025

The 2025 ICD-10-PCS update adds 41 procedure codes, effective April 1, 2024, for inpatient settings. Specifically, these reflect new treatments like immune checkpoint inhibitors. Skyshine ensures hospitals use updated PCS codes to avoid payment delays.

Key Procedure Code Additions

• • • Immune Checkpoint Inhibitors:

For instance, 18 codes track Pembrolizumab effects (T45.AX-).

• • • KCNQ2-Related Epilepsy:

Four codes (G40.43X-) document childhood epilepsy.

• • • Pulmonary Embolism:

Additionally, four codes (I26.03-I26.96) cover fat and cement embolisms.

How Skyshine Health Solutions Can Help

Skyshine specializes in medical billing and accounts receivable management. For instance, we reduce denials and boost revenue. Our services include:

• • • Coding Audits: Ensure ICD-10 and CPT accuracy.

    • EOB Analysis: Resolve denials quickly.

    • HIPAA Compliance: Secure claims protect patient data.

    • Revenue Cycle Optimization: Minimize unpaid claims.

The 2025 ICD-10 updates, effective October 1, 2024, enhance coding specificity. However, practices must adapt to avoid denials. Skyshine Health Solutions ensures compliance and financial stability. For example, our coding expertise reduces unpaid claims. Partner with us to drive sustainable growth.

Learn more from Common Medical Billing Mistakes Clinics Make

Call to Action: Ready to optimize your billing? Contact Skyshine today for a coding audit. Have question about medical billing? Visit out FAQs Page.