Every October brings change for clinical documentation and coding professionals. This year, nearly 75,000 ICD-10-CM codes will be in effect, including 487 new codes, 28 deletions, and multiple revisions.
In our recent webinar, Stay ahead of the curve: Master the 2026 ICD-10-CM updates, IMO Health experts Theresa Rihanek, MHA, RHIA, CCS, Mapping Informaticist; June Bronnert, MHA, RHIA, CCS, CCS-P, VP, Global Clinical Services; and Julie Glasgow, MD, Senior Staff Clinical Terminologist, walked through the updates.
In a hurry? Here are five key takeaways from their discussion.
1. Expanded codes for oncology and genetic susceptibility
Cancer-related coding continues to grow more precise. This year brings:
- New malignant neoplasm codes (C50.A-) to capture inflammatory breast cancer, a rare and aggressive form often mistaken for mastitis
- Expansion of genetic susceptibility codes (e.g., Z15.07) to identify susceptibility to cancers of the fallopian tube, colorectal, and urinary tract.
Rihanek explained, “It’s important to be aware that many genes like BRCA1 or BRCA2 can predispose a patient to many different types of cancer. And you’ll want to pick all of those up.”
2. Recognizing diabetes in remission
For the first time, ICD-10-CM includes E11.A for type 2 diabetes mellitus in remission. Following the 2021 American Diabetes Association (ADA) Consensus report on Type 2 Diabetes in Remission, ICD-10-CM now includes E11.A, Type 2 diabetes in remission. This code cannot be assigned to any documented diabetic complications (e.g., diabetic retinopathy, diabetic ulcer, etc.).
Rihanek emphasized the need for clarity: “The documentation must use the word ‘remission’ rather than terms such as ‘resolved’, ‘cured’, or ‘reversal’ to assign E11.A. And if it’s unclear, you should query the physician.”
3. Rare diseases and emerging conditions get greater visibility
Several new codes address rare genetic and metabolic conditions, ensuring clinicians can better track outcomes. These include:
- Leukocyte adhesion deficiency (D71.1)
- Familial hypercholesterolemia variants (E78.2-)
- Lipodystrophy types (E88.1-)
- Neurodevelopmental disorders related to pathogenic gene variants (new Q0A category)
Bronnert noted, “There has been significant increase in the number of unique codes being requested to capture specific pathogenic gene variants… This is an area where there will continue to be a lot of growth.”
4. New focus on social and environmental factors
ICD-10-CM continues to expand social determinants of health (SDOH). Among this year’s additions:
- Codes for financial insecurity, including difficulty paying utilities and bankruptcy (Z59.861- Z59.869)
- Updates to BMI coding guideline, directing coders to assign the most severe value if there is documentation of fluctuation of the BMI during the admission.
5. Coding for emerging public health concerns
Several updates reflect evolving healthcare realities:
- New codes for various ulcer sites and severity were added (L98.4-) along with codes for toxic effect of xylazine (T36.84-) which highlights the emerging health issue related to the impact of veterinary sedatives found in illicit opioids
- Cannabis hyperemesis syndrome (R11.16), a condition linked to chronic cannabis use
- Gulf War illness is now classified in ICD-10-CM using T75.83-. Codes for exposure to environmental and chemical hazards related to the Gulf war or other war theaters are present at Z77.31 and Z77.39.
Bronnert added, “We are optimistic that the classification will continue to evolve as more users begin to interact with this new area of codes.”
Get ready for ICD-10-CM updates
The 2026 ICD-10-CM updates reinforce a trend: codes are becoming more granular, clinically relevant, and socially aware.
The challenge – and opportunity – is ensuring health documentation keeps pace. As Glasgow reminded attendees, “Terminology is important here.” Clear provider documentation will support accurate coding to ensure that patient conditions are represented appropriately in the health record.
