FY2027 coding changes

Releases in force during FY2027

Recorded changes taking effect in FY2027

• ICD-10-CM FY2027Current release

  Effective October 1, 2026 · 238 added · 21 deleted · 4 description revised · 4 short description revised · 15 billable → non-billable · 1,821 tabular instruction changes

  Added codes (238)Deleted codes (21)Revised descriptions (4)Billable to non-billable (15)Changes by chapter

• ICD-10-PCS FY2027Current release

  Effective October 1, 2026 · 101 added · 38 deleted · 3 description revised

  Added codes (101)Deleted codes (38)Revised descriptions (3)

• HCPCS Level II October 2026Current release

  Effective October 1, 2026 · 45 added · 15 deleted (terminated)

• MS-DRG v44Current release

  Effective October 1, 2026 · 14 DRGs added · 18 DRGs deleted · 22 titles revised

• ASP NDC-HCPCS Crosswalk October 2026Current release

  Effective October 1, 2026 · 327 pairings added · 290 pairings removed · 7 billable-unit changes

Guides verified against FY2027

• “Other” vs “Unspecified,” NEC vs NOS: Which Residual Code Fits the Record· Coding Fundamentals
• “See” vs “See Also” in the Alphabetic Index: When You Must Follow the Cross-Reference· Coding Fundamentals
• 7th Character A, D, or S: “Initial” Does Not Mean First Visit· Code Relationships & Conventions
• Active Cancer or “History Of”: When a C Code Becomes Z85· Common Clinical Coding Problems
• Acute and Chronic Together: When Both Codes Are Reported, and Which Goes First· Special Coding Situations
• After a CABG: Z95.1 Bypass Graft Status, I25.7- and I25.810 Graft Atherosclerosis, and Z48.812 Aftercare· Common Clinical Coding Problems
• Aftercare vs Follow-Up: Healing Care (Z42–Z49) or Surveillance After Treatment Is Complete (Z08–Z09)· Z Codes
• Arthropathy, Osteopathy and Myopathy “in Diseases Classified Elsewhere”· Special Coding Situations
• Artificial Opening Coding: Status, Attention, or Complication?· Z Codes
• Bilateral Knee Osteoarthritis: One Code or Two?· Common Clinical Coding Problems
• Code First, Use Additional Code, and Code Also: What Each Note Requires, and Which Ones Set the Order· Sequencing
• Combination Codes: One Code for Two Conditions, and When a Second Code Is Still Needed· Coding Fundamentals
• Excludes1 vs Excludes2: When Two ICD-10-CM Codes Can Be Reported Together· Code Relationships & Conventions
• History Codes (Z80–Z87): When Is a Condition “History Of” Rather Than Current?· Z Codes
• How Do I Assign the Present on Admission (POA) Indicator? Y, N, U, W and the Exempt List· Special Coding Situations
• How Do I Code a Flu Shot or Other Immunization Visit? Z23 for the Encounter, Z28 When the Vaccine Is Not Given, Z28.3 for Underimmunization Status· Z Codes
• How Do I Code a Myocardial Infarction? I21 for Four Weeks, I22 for a Second MI Within Them, and I25.2 After· Common Clinical Coding Problems
• How Do I Code a Sequela (Late Effect)? Two Codes, the Residual First, and the 7th Character S· Special Coding Situations
• How Do I Code Acute Kidney Injury (AKI)? N17.9, Acute Tubular Necrosis, and AKI on Top of Chronic Kidney Disease· Common Clinical Coding Problems
• How Do I Code Anemia in Chronic Disease? D63.0, D63.1, D63.8 and the Code First Rule· Common Clinical Coding Problems
• How Do I Code COPD? Uncomplicated, With Exacerbation, or With a Lower Respiratory Infection· Common Clinical Coding Problems
• How Do I Code Diabetes With Chronic Kidney Disease?· Common Clinical Coding Problems
• How Do I Code Diabetes With Hyperglycemia or Hypoglycemia? E11.65, E11.64-, and the E16.A Level· Common Clinical Coding Problems
• How Do I Code Diabetes With Multiple Complications? One Code Per Complication, and When E11.8 or E11.69 Applies· Common Clinical Coding Problems
• How Do I Code Diabetes With Neuropathy? E11.40 to E11.49 and the Charcot Joint· Common Clinical Coding Problems
• How Do I Code Diabetes With Retinopathy? Severity, Macular Edema, and Laterality· Common Clinical Coding Problems
• How Do I Code Heart Failure? Type, Acuity, and the Hypertension Combination Codes· Common Clinical Coding Problems
• How Do I Code Hypertension With Chronic Kidney Disease? I12, I13, and the N18 Stage· Common Clinical Coding Problems
• How Do I Code Pneumonia? Organism, Influenza First, Aspiration, and Ventilator-Associated· Common Clinical Coding Problems
• How Do I Code Postpancreatectomy Diabetes Mellitus?· Common Clinical Coding Problems
• How Do I Code Respiratory Failure? Acute, Chronic, or Acute-on-Chronic — and Can It Be Principal?· Common Clinical Coding Problems
• How Do I Code Secondary Diabetes? E08 Due to an Underlying Condition, E09 Drug-Induced, or E13 Other Specified· Common Clinical Coding Problems
• How Is “Threatened Labor” Coded? O47 False Labor, Not O60 Preterm Labor· Common Clinical Coding Problems
• How Many ICD-10-CM Codes Are There? Counts by Fiscal Year, FY2016 to FY2027· Code Relationships & ConventionsFY2027 change: 190 new valid codes, 30 removed (15 deleted, 15 converted to headers), 4 titles revised; 98,403 entries and 74,879 valid codes in total. Effective October 1, 2026.
• How Much Does ICD-10-CM Change Each Year? Eleven Years of Additions, Deletions and Revisions· Code Relationships & ConventionsFY2027 change: 238 added, 21 deleted, 4 revised, 15 billable-status changes. The smallest revision count of the eleven years.
• How to Choose an ICD-10-CM Code: A Step-by-Step Coding Workflow· Coding Fundamentals
• Includes Notes, Inclusion Terms, Parentheses, Brackets, and “And”: How to Read a Tabular Entry· Code Relationships & Conventions
• Laterality: Right, Left, Bilateral, or Unspecified — and What Happens Across Two Encounters· Code Relationships & Conventions
• Manifestation Codes: What Goes First, and Why It Can’t Be the Manifestation· Sequencing
• Poisoning, Adverse Effect, or Underdosing: Which T36–T50 Column, and What Goes First· Special Coding Situations
• Principal Diagnosis vs First-Listed Diagnosis: Which Term Applies, and How Each Is Chosen· Sequencing
• Retained Foreign Body: T81.5 Left During a Procedure, Z18 Fragment Status, or T15–T19 Through an Orifice· Common Clinical Coding Problems
• Screening or Diagnostic? When a Z Screening Code Applies and When the Symptom Leads· Z Codes
• Sepsis, Severe Sepsis, and Septic Shock: How Many Codes, and Which Goes First· Sequencing
• Status Codes: When Should a Z Status Code Be Reported?· Z Codes
• Status or Complication? When a Z Status Code Gives Way to a Complication Code· Z Codes
• Symptom Code or Confirmed Diagnosis: When an R Code Is Right, and When It Is Not· Coding Fundamentals
• The “With” Convention: When ICD-10-CM Presumes Two Conditions Are Related· Code Relationships & Conventions
• The Placeholder “X”: When a Code Needs It, and Why Leaving It Out Invalidates the Code· Code Relationships & Conventions
• Transplant Complication or Transplant Status? T86 vs Z94, and CKD After a Kidney Transplant· Common Clinical Coding Problems
• Traumatic, Pathological, or Stress Fracture: Which Family, and the Osteoporosis Rule· Common Clinical Coding Problems
• Venomous Insect Sting or Bite: A T63 Toxic-Effect Code, Not an Injury Code — and No W57· Common Clinical Coding Problems
• What Are the Medicare Code Editor Edits, and Why Do Individually Valid Codes Fail Them?· Special Coding Situations
• What Does an NCCI Correct Coding Modifier Indicator of 0, 1 or 9 Mean?· CMS Rules & Edits
• What Is an HCC, and What Does the CMS-HCC V28 Mapping Tell a Coder About an ICD-10-CM Code?· CMS Rules & Edits
• When Can a Z Code Be the Primary Diagnosis?· Z Codes
• Which ICD-10-CM Chapters Carry the Most Excludes1 Notes? A Census of the Tabular List· Code Relationships & ConventionsFY2027 change: Net 4 Excludes1 and 9 Excludes2 lines added across Chapters 1, 2, 3, 11, 17, 18 and 21; Chapter 17 retitled to include genetic disorders and extended to QA1. Totals: 5,411 Excludes1, 2,529 Excludes2.
• Which ICD-10-CM Chapters Have Grown the Most Since FY2016? Twelve Years by Chapter· Code Relationships & ConventionsFY2027 change: Chapter 17 (congenital malformations) carries QA0 and QA1, added without a chapter renumbering; its true range is Q00-QA1, wider than the Q00-Q99 many references still show.
• Which ICD-10-CM Codes Have Been Retired? A Twelve-Year Lifespan Census· Code Relationships & ConventionsFY2027 change: 30 codes stopped being reportable: 15 deleted and 15 converted to non-billable parents, D69.1 and I42.0 among them.
• Why the Same Inpatient Claim Can Group to a Different MS-DRG· CMS Rules & Edits
• Your Diagnosis Is Not on the NCD’s List. Does That Mean Medicare Will Not Cover It?· CMS Rules & Edits

Answers published under FY2027

No answer has been published under FY2027 yet.