The proposed ICD-10 code changes — released with the FY2026 Hospital Inpatient PPS (IPPS) proposed rule on April 11 —   include a new code for type 2 diabetes mellitus in remission, more than 100 new codes to capture non-pressure chronic ulcers in various stages as well as new codes for malignant inflammatory neoplasms. 
 
The proposed rule contains 487 new codes, 38 revised code descriptors and 28 codes deemed invalid. If finalized, these changes would take effect Oct. 1. 
 
A proposal including the new code for type 2 diabetes mellitus in remission was previously discussed during the virtual ICD-10-CM Coordination and Maintenance (C&M) Committee meeting in March 2024. 
 
The proposed new code, E11.A  (Type 2 diabetes mellitus in remission), would fall under E11 (Type 2 diabetes mellitus). 
 
The meeting proposal stated that the new code will help with reporting the clinical status of regression along the diabetes continuum in alignment with the current clinical guidelines. 
 
Non-pressure chronic ulcers 
 
Also proposed are 111 new codes to capture non-pressure chronic ulcers under categories L89.4- and L89.A-, with most specifying both the location of the ulcer on the body as well as the staging/appearance. 
 
For example, among these proposed codes are:  
 
  • L98.431 (Non-pressure chronic ulcer of abdomen limited to breakdown of skin) 
  • L98.443 (Non-pressure chronic ulcer of chest with necrosis of muscle) 
  • L98.452 (Non-pressure chronic ulcer of neck with fat layer exposed) 
There are also a few codes proposed for other/unspecified severity such as: 
 
  • L98.A118 (Non-pressure chronic ulcer of right upper arm with other specified severity) 
  • L98.A119 (Non-pressure chronic ulcer of right upper arm with unspecified severity) 
Malignant inflammatory neoplasms 
 
The proposed code update also includes three new codes to capture malignant inflammatory neoplasms. 
If finalized, the new codes would be: 
 
  • C50.A0 (Malignant inflammatory neoplasm of unspecified breast) 
  • C50.A1 (Malignant inflammatory neoplasm of right breast) 
  • C50.A2 (Malignant inflammatory neoplasm of left breast) 
A proposal for these codes was presented at the September 2024 ICD-10 C&M Committee meeting, which stated that the new codes would allow physicians to more readily identify patients with this form of breast cancer, facilitate earlier treatments and raise awareness about inflammatory breast cancer in the clinical community. 
 
 Thyroid orbitopathy 
 
New codes for Thyroid Eye Disease (TED) were also included in the proposed code update. 
 
These codes were also discussed during the March 2024 C&M meeting where it was stated that TED is common among patients with thyroid disease, which make up a large number of home health patients, but there is currently no ICD-10 code for it. 
 
If finalized, the new codes would be: 
 
  • H05.831 (Thyroid orbitopathy, right eye) 
  • H05.832 (Thyroid orbitopathy, left eye) 
  • H05.833 (Thyroid orbitopathy, bilateral) 
  • H05.839 (Thyroid orbitopathy, unspecified eye) 
Additional proposed updates:
  • Some 213 new codes would be added to Chapter 19 to allow injury coding by laterality and depth, with conditions including contusions, lacerations, puncture wounds and open bites. Example: S31.646A (Puncture wound of abdominal wall with foreign body, right flank with penetration into peritoneal cavity, initial encounter). 
  • Keep an eye on an expansion of eyelid-inflammation code H01.8 (Other specified inflammations of eyelid), which will expand into nine laterality codes based on whether the upper, lower or both eyelids are involved. For example: H01.85 (Other specified inflammation of left lower eyelid) or H01.8A (Other specified inflammation of right eye, upper and lower eyelids).
  • Prepare to code pelvic and perineal pain at a higher level of specificity. Code R10.2 (Pelvic and perineal pain) will be replaced with five laterality codes for pelvic and perineal pain unspecified side (R10.20), right side (R10.21), left side (R10.22) and bilateral pain (R10.23). A sixth code will describe suprapubic pain (R10.24).
  • You also will find additional codes in the Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified chapter for pain and tenderness, if the proposed code set is finalized. Proposed new codes include abdominal pain of multiple sites (R10.85), laterality codes for tenderness or pain of the flank, such as R10.8A1 (Right flank tenderness) and R10.A3 (Flank pain, bilateral). Four additional codes describe costovertebral tenderness such as R39.853 (Costovertebral [angle] tenderness, bilateral).
  • Other new signs and symptoms codes will include a code for intense vomiting associated with marijuana use R11.16 (Cannabis hyperemesis syndrome).
  • Social determinants of health code Z59.86 (Financial insecurity) will be expanded into three codes that describe difficulty paying for utilities (Z59.861), other specified financial insecurity (Z59.868) or unspecified financial insecurity (Z59.869).
  • You’ll also find two new codes for soldiers and other people who have been in war zones based on the theater of war: Z77.31 (Contact with and [suspected] exposure to Gulf War theater) and Z77.39 (Contact with and [suspected] exposure to other war theater).  
For a full story of the proposed code update, see upcoming issues of Home Health Line and Diagnosis Coding Pro for Home Health. 
 
To view the rule and tables, visit https://tinyurl.com/49c5j7wd.