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Editor's E-Note
The 2026 ICD-10 update went into effect on April 1, and there is a notable change. Although there were no additions, deletions, or revisions among the diagnosis codes, the procedure codes added 80 and subtracted two. Importantly, the logic behind the coding was revamped. What this means for health care organizations is that they need to consider the reasons behind the coding if they want to maximize reimbursement and minimize denials. Read on for an in-depth report on what coders and coding departments need to know.
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— Dave Yeager, editor |
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ICD-10 Update Changes Coders’ Thinking
By Leigh Poland, RHIA, CCS, CDIP, CIC
The 2026 ICD-10 update from the CMS and the National Center for Health Statistics, which took effect April 1, appears uneventful on the surface. The ICD-10-CM diagnosis code set saw no additions, deletions, or revisions, and the Official Coding Guidelines stay unchanged. However, focusing only on the code count misses the real story.
The April update is fundamentally structural. Rather than expanding the diagnosis code set, it modifies the logic governing how diagnoses relate to one another within the classification system. Using targeted revisions to instructional notes, exclusions, and sequencing guidance, the update shifts how coders arrive at answers rather than what answers are available.
The ICD-10-PCS procedure classification expands by 80 new procedure codes and removes two existing ones. This reflects persistent innovation in cardiac pacing technologies, hepatobiliary endoscopic drainage techniques, reconstructive urologic surgery, rehabilitation therapies, and emerging biologic treatments.
For inpatient coding teams, clinical documentation integrity leaders, and revenue integrity professionals, the operational ramifications, such as coding variability, reimbursement shifts, and new compliance challenges, are more significant than the update’s modest appearance suggests.
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Epic, Oracle, and Cleveland Clinic Among Companies Joining CMS Prior Authorization Initiative
Twenty-nine health care organizations including EHR vendors, data networks, insurers, and health systems have signed on to the CMS’s push to streamline prior authorization, Fierce Healthcare reports.
UM-Flint Health Informatics and Information Management Program Graduates First Class
The University of Michigan-Flint is graduating the inaugural class in its Bachelor of Science in Health Informatics and Information Management online program, which blends advanced technology and health care. |
Have a coding or documentation question? Get an expert answer by sending an email to edit@gvpub.com.
This month’s selection:
I was wondering if you could provide me some coding/documenting requirements for CPT codes 95251 and 95249 with information on incident to billing also?
Jessica Fiorelli RHIT, CCS, CCS-P
Coding/Billing Team Lead
Columbus Family Practice
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Hippocratic AI Launches Polaris 5.0
Hippocratic AI has announced Polaris 5.0, the latest generation of its health care-specialized AI. New clinical skills and upgraded features make it the most medically advanced voice AI agent in health care. Polaris 5.0 performs well on the clinical, regulatory, and conversational tasks that enable voice AI to be deployed in real care settings: clinical accuracy, HIPAA and regulatory compliance, empathy in patient interaction, and consistency across complex, multistep conversations.
AdvancedMD Rolls Out eMAR Solution
AdvancedMD has announced the launch of the AdvancedMD Electronic Medication Administration Record (eMAR) that simplifies medication workflows, serving as a central hub for medication scheduling, administration, and documentation. Integrated directly within the AdvancedMD EHR platform, the eMAR solution is designed specifically for behavioral health, substance use disorder treatment, long term care, and specialty clinical environments. |
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