The ICD-10 (International Classification of Diseases, 10th Revision) coding system is a globally recognized framework used to classify and code various diagnoses, symptoms, and procedures. For chiropractors, ICD-10 serves as a critical tool for billing insurance payers, tracking patient health trends, and supporting healthcare policy decisions.
ICD-10 codes have a complex alphanumeric structure, with each code providing a precise description of a medical condition or procedure. For instance, the structure includes categories, subcategories, and specific codes that allow for more detailed documentation of a patient’s health status. This system helps standardize the health information, making it easier to communicate between chiropractic providers, payers, and regulatory bodies, ensuring consistency and clarity in medical records.
Staying current with ICD-10 2025 Updates
The ICD-10 coding system is regularly updated to reflect advances in healthcare knowledge, changes in disease prevalence, and improvements in treatment approaches. The Center for Medicare and Medicaid Services has released the FY 2025 updates to the ICD-10 codes for diagnosis. There are fewer new codes this year compared to last year, but many interesting new codes are being added in 2025 ICD-10 updates.
Staying current with ICD-10 2025 updates is crucial for chiropractic providers and billers alike. These ICD-10 updates for 2025 impact insurance billing by adding, revising, or removing codes to accommodate new diagnostic criteria or treatment methods.
Adopting these changes is essential for accurate billing, as using outdated codes can result in rejected claims, reduced reimbursements, and potential compliance issues.
It also directly impacts the quality of patient care by ensuring that diagnoses and treatments are properly documented and classified.
This blog provides an in-depth look at the key changes in the ICD-10-CM codes for 2025. Here’s a summary of what to expect:
- New and Revised Diagnosis Codes: We’ll cover the newly introduced codes and any modifications to existing codes, helping you stay current with the latest diagnostic categories and criteria.
- Specialty-Specific Updates: Discover which medical specialties and conditions are most impacted by the ICD-10 code changes for 2025. This section will highlight changes in areas like orthopedics, mental health, cardiology, and more, to help providers better understand relevant adjustments.
Deleted Codes: Lastly, we’ll review any codes that have been retired or removed, ensuring that you avoid outdated codes in your practice’s billing and documentation.
List of new ICD-10 codes for 2025
With the 2025 ICD-10-CM updates, chiropractic providers and healthcare professionals can document patient conditions more precisely, leading to improved patient care and optimized billing accuracy.
In total, 324 codes were added, revised and deleted in the 2025 ICD-10-CM code set, effective October 1, 2024. 252 new codes, 36 code deletions, and 13 code revisions making the cut, going into effect on October 1, 2024. As ICD-10 codes directly influence reimbursement rates, the new ICD-10 billing codes also provide an opportunity for practices to align their documentation and billing practices with the latest standards, minimizing errors and maximizing revenue stability.
The table below shows the list of ICD diagnosis codes updates by chapter of ICD-10-CM.
| ICD-10-CM Chapter | New | Revised | Invalid |
| Chapter 1: Certain Parasitic and Infectious Diseases | 0 | 1 | 0 |
| Chapter 2: Neoplasms | 63 | 0 | 14 |
| Chapter 3: Diseases of the Blood and Blood Forming Organs | 1 | 0 | 0 |
| Chapter 4: Endocrine, Nutritional and Metabolic Diseases | 16 | 0 | 0 |
| Chapter 5: Mental, Behavioral and Neurodevelopmental Disorders | 26 | 1 | 4 |
| Chapter 6: Diseases of the Nervous System | 7 | 1 | 1 |
| Chapter 7: Diseases of the Eye and Adnexa | 0 | 5 | 0 |
| Chapter 8: Diseases of the Ear and Mastoid Process | 0 | 0 | 0 |
| Chapter 9: Diseases of Circulatory System | 4 | 2 | 0 |
| Chapter 10: Diseases of the Respiratory System | 7 | 0 | 0 |
| Chapter 11: Diseases of the Digestive System | 27 | 1 | 3 |
| Chapter 12: Diseases of the Skin and Subcutaneous Tissue | 8 | 0 | 3 |
| Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue | 33 | 0 | 3 |
| Chapter 14: Diseases of the Genitourinary System | 0 | 0 | 0 |
| Chapter 15: Pregnancy, Childbirth and the Puerperium | 0 | 0 | 0 |
| Chapter 16: Certain Conditions Originating in the Perinatal Period | 0 | 0 | 0 |
| Chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities | 4 | 1 | 1 |
| Chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified | 1 | 0 | 0 |
| Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes | 30 | 0 | 3 |
| Chapter 20: External Causes of Morbidity | 0 | 0 | 0 |
| Chapter 21: Factors Influencing Health Status and Contact with Health Services | 25 | 1 | 2 |
| Chapter 22: Codes for Special Purposes | 0 | 0 | 0 |
| Total | 252 | 13 | 34 |
Chapter-Wise Changes to ICD-10 Codes for 2025
The 2025 ICD-10-CM updates introduce a range of new and revised codes across different chapters, helping healthcare providers document patient diagnoses with more specificity. Here’s a breakdown of notable additions and changes in each chapter:
Chapter 2: Neoplasms
This year, 63 new diagnosis codes have been added under the lymphoma category (C81-C88). These ICD-10 code description are divided based on whether the condition is “in remission” or “not having achieved remission,” offering greater precision in documenting patient status.Each code specifies whether the condition is “in remission” or “not having achieved remission.”
| Code Added | Code Description |
| C81.0A | Nodular lymphocyte predominant Hodgkin lymphoma, in remission |
| C81.1A | Nodular sclerosis Hodgkin lymphoma, in remission |
| C81.2A | Mixed cellularity Hodgkin lymphoma, in remission |
| C81.3A | Lymphocyte-depleted Hodgkin lymphoma, in remission |
| C81.4A | Lymphocyte-rich Hodgkin lymphoma, in remission |
| C81.7A | Other Hodgkin lymphoma, in remission |
| C81.9A | Hodgkin lymphoma, unspecified, in remission |
| C82.0A | Follicular lymphoma grade I, in remission |
| C82.1A | Follicular lymphoma grade II, in remission |
| C82.2A | Follicular lymphoma grade III, unspecified, in remission |
| C82.3A | Follicular lymphoma grade IIIa, in remission |
| C82.4A | Follicular lymphoma grade IIIb, in remission |
| C82.5A | Diffuse follicle center lymphoma, in remission |
| C82.6A | Cutaneous follicle center lymphoma, in remission |
| C82.7A | Follicular lymphoma, unspecified, in remission |
| C83.0A | Small cell B-cell lymphoma, in remission |
| C83.1A | Mantle cell lymphoma, in remission |
| C83.390 | Primary central nervous system lymphoma |
| C83.398 | Diffuse large B-cell lymphoma of other extranodal and solid organ sites |
| C83.3A | Diffuse large B-cell lymphoma, in remission |
| C83.5A | Lymphoblastic (diffuse) lymphoma, in remission |
| C83.7A | Burkitt lymphoma, in remission |
| C83.8A | Other non-follicular lymphoma, in remission |
| C83.9A | Non-follicular (diffuse) lymphoma, unspecified, in remission |
| C84.0A | Mycosis fungoides, in remission |
| C84.1A | Sezary disease, in remission |
| C84.4A | Peripheral T-cell lymphoma, not elsewhere classified, in remission |
| C84.6A | Anaplastic large cell lymphoma, ALK-positive, in remission |
| C84.7A | Anaplastic large cell lymphoma, ALK-negative, in remission |
| C84.9A | Mature T/NK-cell lymphoma, unspecified, in remission |
| C84.AA | Cutaneous T-cell lymphoma, unspecified, in remission |
| C84.AB | Other mature T/NK-cell lymphoma, unspecified, in remission |
| C85.2A | Mediastinal (thymic) large B-cell lymphoma, in remission |
| C85.8A | Other specified types of non-Hodgkin lymphoma, in remission |
| C85.9A | Non-Hodgkin lymphoma, unspecified, in remission |
| C86.00 | Extranodal NK/T-cell lymphoma, nasal type not having achieved remission |
| C86.01 | Extranodal NK/T-cell lymphoma, nasal type, in remission |
| C86.10 | Hepatosplenic T-cell lymphoma not having achieved remission |
| C86.11 | Hepatosplenic T-cell lymphoma, in remission |
| C86.20 | Enteropathy-type (intestinal) T-cell lymphoma not having achieved remission |
| C86.21 | Enteropathy-type (intestinal) T-cell lymphoma, in remission |
| C86.30 | Subcutaneous panniculitis-like T-cell lymphoma not having achieved remission |
| C86.31 | Subcutaneous panniculitis-like T-cell lymphoma, in remission |
| C86.40 | Blastic NK-cell lymphoma not having achieved remission |
| C86.41 | Blastic NK-cell lymphoma, in remission |
| C86.50 | Angioimmunoblastic T-cell lymphoma not having achieved remission |
| C86.51 | Angioimmunoblastic T-cell lymphoma, in remission |
| C86.60 | Other mature T/NK-cell lymphomas not having achieved remission |
| C86.61 | Primary cutaneous CD30-positive T-cell proliferations, in remission |
| C88.00 | Waldenstrom macroglobulinemia not having achieved remission |
| C88.01 | Waldenstrom macroglobulinemia, in remission |
| C88.20 | Heavy chain disease not having achieved remission |
| C88.21 | Heavy chain disease, in remission |
| C88.30 | Immunoproliferative small intestinal disease not having achieved remission |
| C88.31 | Immunoproliferative small intestinal disease, in remission |
| C88.40 | Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT-lymphoma) not having achieved remission |
| C88.41 | Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT-lymphoma), in remission |
| C88.80 | Other malignant immunoproliferative diseases not having achieved remission |
| C88.81 | Other malignant immunoproliferative diseases in remission |
| C88.90 | Malignant immunoproliferative disease, unspecified, not having achieved remission |
| C88.91 | Malignant immunoproliferative disease, unspecified, in remission |
ICD-10 Code Updates for Hypoglycemia and Obesity in Chapter 4
This chapter now includes specific codes that add classifications for hypoglycemia and obesity, enhancing diagnostic clarity. These updates define levels of severity for hypoglycemia and classes of obesity, enabling more precise documentation and billing.
New Codes:
- Hypoglycemia:
- E16.A2: Hypoglycemia, Level 2
- E16.A3: Hypoglycemia, Level 3
- Obesity:
- E66.81: Obesity classification
- E66.811: Obesity, Class 1
- Citrate Metabolism Disorders:
- E74.82: Disorders of citrate metabolism
- E74.820: SLC13A5 Citrate Transporter Disorder
- E74.829: Other disorders of citrate metabolism
2025 ICD-10-CM Code Updates for Mental Health and Digestive Disorders
In the 2025 update of ICD-10-CM, Chapter 5, which covers Mental and Behavioral Disorders, introduces more specificity to eating disorders by adding classifications for type and severity. Additionally, two new codes have been added to address specific mental and behavioral conditions in adults.
| Code | Description |
| F50.010 | Anorexia nervosa, restricting type, mild |
| F50.023 | Anorexia nervosa, binge eating/purging type, extreme |
| F50.21 | Bulimia nervosa, mild |
| F50.814 | Binge eating disorder, in remission |
| F50.83 | Pica in adults |
| F50.84 | Rumination disorder in adults |
These changes help healthcare providers capture a more detailed picture of eating disorders in terms of their severity and subtype, improving treatment tracking and documentation.
Updated ICD-10 Codes for Digestive System Disorders Chapter 11
Changes to Chapter 11, addressing Diseases of the Digestive System, introduces fifth- and sixth-character codes to provide greater detail on the complexity of certain conditions related to fistulas. The new codes allow for specific classification of anal, rectal, and anorectal fistulas based on complexity, recurrence, and persistence.
| Code | Description |
| K60.311 | Anal fistula, simple, initial |
| K60.32 | Anal fistula, complex |
| K60.413 | Rectal fistula, simple, recurrent |
| K60.422 | Rectal fistula, complex, persistent |
| K60.50 | Anorectal fistula, unspecified |
| K60.519 | Anorectal fistula, simple, unspecified |
| K60.522 | Anorectal fistula, complex, persistent |
ICD-10 2025 Changes to Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue
In the updated ICD-10 codes for 2025, Chapter 13 has expanded on conditions related to intervertebral disc degeneration (category M15), particularly focusing on the lumbar and lumbosacral regions. This update introduces greater specificity to diagnose pain in these areas, helping practitioners capture detailed information about the patient’s pain distribution:
Back pain only: Used when pain is confined to the back.
Leg pain only: Applicable if pain radiates down the leg, as seen in sciatica.
Both back and leg pain: For cases where pain affects both regions.
No specific pain location: Used when the documentation does not specify the pain location.
Additionally, diagnosis code M659, representing “Synovitis and tenosynovitis, unspecified,” has been expanded into 24 new codes. Each new code specifies the affected body part (e.g., shoulder, arm, hand, thigh, ankle, and foot). These detailed codes improve diagnostic accuracy by allowing chiropractors to precisely identify the location of synovitis or tenosynovitis. The updated codes are shown in the table below for reference.
| Codes Added | Categories |
| M65.90 | Unspecified synovitis and tenosynovitis, unspecified site |
| M65.911 | Unspecified synovitis and tenosynovitis, right shoulder |
| M65.912 | Unspecified synovitis and tenosynovitis, left shoulder |
| M65.919 | Unspecified synovitis and tenosynovitis, unspecified shoulder |
| M65.921 | Unspecified synovitis and tenosynovitis, right upper arm |
| M65.922 | Unspecified synovitis and tenosynovitis, left upper arm |
| M65.929 | Unspecified synovitis and tenosynovitis, unspecified upper arm |
| M65.931 | Unspecified synovitis and tenosynovitis, right forearm |
| M65.932 | Unspecified synovitis and tenosynovitis, left forearm |
| M65.939 | Unspecified synovitis and tenosynovitis, unspecified forearm |
| M65.941 | Unspecified synovitis and tenosynovitis, right hand |
| M65.942 | Unspecified synovitis and tenosynovitis, left hand |
| M65.949 | Unspecified synovitis and tenosynovitis, unspecified hand |
| M65.951 | Unspecified synovitis and tenosynovitis, right thigh |
| M65.952 | Unspecified synovitis and tenosynovitis, left thigh |
| M65.959 | Unspecified synovitis and tenosynovitis, unspecified thigh |
| M65.961 | Unspecified synovitis and tenosynovitis, right lower leg |
| M65.962 | Unspecified synovitis and tenosynovitis, left lower leg |
| M65.969 | Unspecified synovitis and tenosynovitis, unspecified lower leg |
| M65.971 | Unspecified synovitis and tenosynovitis, right ankle and foot |
| M65.972 | Unspecified synovitis and tenosynovitis, left ankle and foot |
| M65.979 | Unspecified synovitis and tenosynovitis, unspecified ankle and foot |
| M65.98 | Unspecified synovitis and tenosynovitis, other site |
| M65.99 | Unspecified synovitis and tenosynovitis, multiple sites |
2025 Updates to Chapter 19: Injury, Poisoning, and Certain Other Consequences of External Causes
This update adds 30 new codes, covering:
- Poisoning and adverse effects from immune checkpoint inhibitors and immunostimulant drugs (T45.Axxx).
- Expanded codes for surgical wound disruptions (T81.32) including:
- Gastrointestinal tract anastomosis repair
- Closure of abdominal wall muscle or fascia wounds
- Closure of other specified internal surgical wounds
- Unspecified surgical wound closures
2025 Updates to Chapter 21: Factors Influencing Health Status and Contact with Health Services
This section introduces 25 new codes and removes two, including updates for:
- Genetic susceptibility to epilepsy and obesity (Z15)
- Estrogen and hormone receptor status (Z17)
- Aftercare for sepsis (Z51)
- Housing and economic circumstances related to insurance (Z59)
- Duffy blood type (Z67)
- Pediatric BMI (Z68)
- Personal history of colon polyps (Z86)
These additions improve diagnostic specificity in health status and post-treatment contexts.
ICD-10-CM Coding Guidelines Updates for 2025
The updates to the ICD-10-CM Official Guidelines for Coding and Reporting for 2025 are largely minimal. Most changes are aimed at maintaining consistency in the references within the guidelines, particularly in light of the new codes introduced this year.
Key points to note:
- Consistency in Terminology: Adjustments have been made to ensure uniformity in how terms and coding conventions are referenced throughout the guidelines.
- New Codes Integration: As new codes are added to the ICD-10-CM, the guidelines reflect these additions to provide clarity on their appropriate use.
- Clarifications: Some sections have been clarified to enhance understanding, but there are no major shifts in coding practices or principles.
Implementing ICD-10-CM Changes for 2025 Across Your Practice
As ICD-10 continues to evolve, the emphasis on specifying details of medical conditions aligns with new rulings concerning payment processes, data transfer, and transparency within the medical community. To ensure your organization is prepared for the upcoming changes, it’s essential to implement the updates across all systems before the October 1st deadline.
Key Steps for Implementation:
- Review Updates Thoroughly: Familiarize your team with the 2025 ICD-10-CM changes. Understand how these updates impact your coding practices and clinical documentation.
- System Updates: Ensure that all coding and billing software systems are updated to reflect the new codes. This is crucial for accurate claims submission and reimbursement.
- Leverage Technology: Utilizing the best chiropractic billing software, such as zHealth, can significantly streamline the process. zHealth chiropractic billing software automatically incorporate updated codes, allowing for efficient invoice creation and claims submission with just a few clicks.
- Training and Education: Provide training sessions for your coding and billing staff to ensure they are comfortable with the new codes and any changes in documentation requirements.
- Communication with Insurance Payers: Maintain open lines of communication with insurance companies to understand any specific requirements related to the new coding updates.
- Monitor Compliance: Establish a system for monitoring compliance with the updated guidelines to ensure that your organization remains in good standing and minimizes claim denials.
By taking these proactive steps, healthcare providers and health plans can ensure a smooth transition to the ICD-10 2025 updates, ultimately improving patient care and operational efficiency.
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