More than 250 new ICD-10-CM codes in 2025 IPPS proposed rule

Wednesday, April 24, 2024

CMS proposed hundreds of ICD-10-CM code changes in the 2025 Hospital Inpatient Prospective Payment System (IPPS) proposed rule and fact sheet, published April 10, including:

  • 252 new codes
  • 13 revised codes
  • 36 invalidated codes

Proposed additions

Highlights of the proposed additions include codes to report the following conditions or to report them with additional specificity:

  • Anal, rectal, and anorecta fistula
  • Eating disorders (i.e., anorexia nervosa, bulimia nervosa, binge eating disorder)
  • Follicular lymphoma classifications
  • Hypoglycemia
  • Insufficient health insurance or welfare support
  • Intervertebral disc degeneration
  • Sepsis aftercare
  • Synovitis and tenosynovitis (unspecified)
  • Type 1 diabetes mellitus, presymptomatic

Proposed revisions

The conditions with proposed code revisions include degenerative myopia with associated ocular conditions, rumination disorder of infancy and childhood, and irritable bowel syndrome, unspecified.

Proposed invalidations

Many of the proposed code invalidations consist of removing codes and turning them into subcategories to make room for more specified code additions. For example, current ICD-10-CM code F50.01 (anorexia nervosa, restricting type) would be deleted and changed into subcategory F50.01- to make way for proposed codes:

  • F50, 010, anorexia nervosa, restricting type, mild
  • F50.011, anorexia nervosa, restricting type, moderate
  • F50.012, anorexia nervosa, restricting type, severe
  • F50.013, anorexia nervosa, restricting type, extreme
  • F50.014, anorexia nervosa, restricting type, in remission

Other proposed invalidations include codes for disruption of internal operation (surgical) wound, T-cell lymphoma, and personal history of colonic polyps.

Revenue integrity professionals can view the entire list of proposed 2024 ICD-10-CM code updates in Tables 6A-6J of the rule. CMS encourages community members to comment on these proposed changes until June 10 at 5 p.m. Eastern. Accepted changes will be included in the 2025 ICD-10-CM code set and will be implemented October 1.

Editor's note: See more NAHRI coverage of the 2025 IPPS proposed rule here.