What’s New in ICD-10-CM for FY 2026? From Pelvic Pain to Cannabis Reactions—Here’s What You Need to Know

It’s that time again—ICD-10-CM updates are rolling in for FY 2026, and the coding landscape is evolving across multiple specialties. From digestive symptoms to genetic markers and even eyelid inflammation (yes, really), here’s a rundown of the key changes coming your way, with just enough detail to keep your charts clean and your audits happy.

🚨 GI and Abdominal Symptoms: Getting Specific
The R10.2 series just got a lot more granular. Sixteen new R codes have been added to describe pain and tenderness with pinpoint precision—from pelvic and perineal to abdominal and flank regions. This boosts documentation quality and reflects more accurate patient complaints, so goodbye vague belly pain, hello specificity.

Also worth noting: Cannabis hyperemesis syndrome (CHS) now has its own code—R11.16. If you’ve seen patients dealing with chronic nausea and vomiting from long-term cannabis use, now you can capture that clearly in your coding.

Plus, there are five new codes for documenting costovertebral angle tenderness, so you can now differentiate what was once a catch-all.

🧬 Immunology & Labs: Serum Codes Restructured
Code R76.8- has been converted to a parent code, with R76.89 added to cover unspecified elevated immunoglobulins. This lets you code immune abnormalities with greater clarity, especially when lab values don’t fit neatly into other categories.

💡 Z Codes: Social Context Just Got Smarter
Your social determinants of health (SDoH) documentation is about to get a power-up. Code Z59.86 (Financial insecurity) is now a parent code with three new child codes to help reflect patients’ specific financial hardship situations.

Additionally, new Z77.3- codes let you report exposure to war zones—an unfortunate but increasingly relevant coding option. Food allergy documentation is also getting more specific: milk and egg allergies have new breakdowns under Z91.011 and Z91.012, respectively.

🧬 Oncology: Big News for Genetic Susceptibility
Big updates are coming in cancer genetics:

C50.A- is now a parent code for inflammatory breast cancer (IBC).

Z15.06- is your new go-to for genetic susceptibility to digestive system cancers, including Z15.060 for colorectal cancer.

You'll also see changes for neutrophil function disorders (D71.-) and more options under MS diagnoses (spoiler: G35.- is now a parent code).

🏥 ED Coders: It’s Your Time to Shine
New trauma codes are on the scene—S30.11–S30.13 now allow you to specify contusions of the abdomen, groin, and flank.

And if your ED deals with food-triggered anaphylaxis, you’re in luck. You can now document whether patients react to milk or egg but can tolerate baked forms, thanks to codes like T78.07- and T78.080-. It's like a “gluten-free-but-okay-with-sourdough” menu for diagnosis.

🧠 Neuro & Genetics: MS, Usher Syndrome, and More
G35. is now a parent code, expanding options for multiple sclerosis subtypes like relapsing-remitting and primary progressive MS.

You’ll also see new codes for Usher syndrome and other neurodevelopmental disorders linked to genetic variants, under the brand-new QA0.- series.

👁️ Eye Health: Don’t Blink or You’ll Miss It
Chapter 7 brings 19 new eye-related codes, including laterality-specific additions for thyroid orbitopathy (H05.83-) and angle-closure glaucoma (H40.84-). Plus, H01.8- becomes a parent code for eyelid inflammation, so you can finally distinguish right-upper-lid issues from left-lower-lid problems.

💪 Musculoskeletal: Rheumatoid Factor Gets an Upgrade
The M05.A code has been added for rheumatoid arthritis with abnormal rheumatoid and anti-CCP antibodies, enhancing clinical documentation. Additional tweaks include revised descriptions for toe joint issues and myositis ossificans in the upper arms.

🔬 Genitourinary: More Detail in Kidney Conditions
New subcategories under N00.B- and N04.B- now distinguish between idiopathic and secondary immune membranoproliferative glomerulonephritis (IC-MPGN). Plus, N07.B lets you report hereditary nephropathy linked to APOL1—critical for patients with genetic risk factors.

💊 Drug Reactions: Fluoroquinolones in the Spotlight
If you’ve ever needed more nuance when coding adverse reactions to fluoroquinolone antibiotics, now you’ve got it. The new parent code T36.A- allows for specifying accidental poisoning, underdosing, or adverse effects.

Need the Full List?

CMS released the complete FY 2026 ICD-10-CM update on June 6, 2025. You can access the official documentation directly on the CMS website, but we recommend a double shot of espresso first—it’s a beast.

Bottom Line
More codes, more specificity, and more room for accuracy. Whether you're on the frontlines of the ED, managing oncology charts, or cleaning up MS claims, these updates are designed to align better with real-world clinical detail and evolving care scenarios.

Stay sharp, coders—the ICD-10 game just leveled up.


What’s New in ICD-10-CM for FY 2026? From Pelvic Pain to Cannabis Reactions—Here’s What You Need to Know
sign and complete your progress notes for better financial health
By 7131632906 June 2, 2025
“I’ll finish that progress note later…” Famous last words of a clinic slowly bleeding revenue. If we had a nickel every time someone said that, we’d have a team of scribes, a full-time massage therapist in the breakroom, and a magical Keurig that brews endless coffee on demand. But while progress notes may not win popularity contests among providers, they are—in no uncertain terms—the backbone of your revenue cycle. That little note you delay writing? It’s not just documentation. It’s a billing ticket. It’s a compliance shield. It’s the key to getting paid and staying out of trouble. So let’s take a journey—tongue-in-cheek, but truth-heavy—through why finishing that progress note isn't just helpful. It's everything. The Progress Note: More Than Just CYA (But Also Definitely CYA) You already know progress notes are part of the patient’s medical record. But in the billing world, they’re not just documentation—they are evidence. Think of them as receipts for the care you've delivered. Without them, your billing department is flying blind and the payers are holding onto their checkbooks with suspicion. Your note is what tells the coder what level to bill. It's what tells the auditor you actually performed the services. And it's what tells Medicare, Medicaid, or Blue Cross that no, you didn’t just spend 40 minutes chatting about WebMD. You delivered bona fide, billable care. And if you're audited and that note isn’t done—or worse, it’s copy-pasted nonsense from 2019—then you’re not just out the money. You might be out a lot of money. Possibly your NPI number, too. So yes, your progress note is most certainly your CYA cape. “If It’s Not Documented, It Didn’t Happen.” – Every Payer, Ever Let’s play a game: You saw a patient, did a detailed exam, provided a diagnosis, and mapped out a killer care plan. But you didn’t chart it. What did the insurance company say happened? Nothing. That’s what they think happened. In fact, they won’t pay you for what you did. They’ll only pay you for what you wrote that you did. And if what you wrote is "Seen. Stable. Follow-up," well…congrats. You’ve just downgraded yourself to a 99212. Hope you enjoyed working for $35. The Billing Cycle: A Delicate Dance That Starts With YOU Let’s follow the billing cycle, shall we? 1.Patient visit: You provide care. 2. Documentation: You chart your progress note. 3. Coding: Someone (hopefully trained and not a frustrated office manager moonlighting as a coder) reads that note and assigns the CPT and ICD-10 codes. 4. Billing: The claim goes out. 5.Reimbursement: You get paid. 6.Denials: Because someone wrote “HTN” and nothing else. Notice how step 2 is everything? If you don’t complete the note, nothing moves. Coders can’t code. Billers can’t bill. And your revenue gets stuck in limbo, like a Netflix show canceled mid-season. Worse, incomplete or vague notes lead to incorrect coding, and incorrect coding leads to denials or underpayments. Denials cost time. Resubmissions cost energy. And underpayments cost you actual revenue, which you’ll never get back. Delay Today, Deny Tomorrow Here’s a fun (read: horrifying) fact—most payers have timely filing limits. That means if your claim isn’t submitted within a certain timeframe—say, 90 days—you don’t get paid. Period. No appeal. No phone call to a sympathetic rep. Just a hard stop. Now, imagine how many practices lose revenue simply because a progress note wasn’t finished on time. One note here, two notes there, and boom—$10,000 in unreimbursed visits. That’s not an exaggeration. That’s Tuesday in a busy primary care clinic. Compliance is Not Optional (Even if You Really Hate Charting) In the post-COVID, audit-heavy world, payers (especially CMS) are watching like hawks. They’re targeting over-documentation, under-documentation, and documentation that looks like it was Xeroxed from another chart entirely. The progress note is your legal proof that: You saw the patient. You provided the service. The level of service matches what you billed. Without that, you’re not just risking non-payment—you’re risking recoupments or fines. And nobody wants to see a note retro-audited three years later and realize the diagnosis was documented in the Plan section, and nowhere else. Common Excuses (And Why They’ll Bankrupt You) Let’s deconstruct some of the classics: "I’ll chart at the end of the day." That’s great, if you only see one patient a day. For everyone else, this is how you end up in charting purgatory at 8:30 p.m. with fried brain cells and vague memories of "the lady with the rash." "The biller can figure it out." Nope. Your biller isn’t a mind reader. They need you to clearly, accurately, and legibly document what you did. They can’t code “probably did a physical.” "It’s all in my head." Unfortunately, heads don’t submit claims. Progress notes do. How to Make Documentation Suck Less Let’s not pretend charting is fun. But you can make it less painful. Use templates—but customize them. Avoid the dreaded "normal exam" for a patient who had a broken femur. Invest in ambient listening. Tools like Suki (integrated with Azalea Health, for example) help you chart while you talk. Chart in real time. The longer you wait, the fuzzier the details. Delegate wisely. Let your MA start the note or preload templates. You focus on the medical decision-making. Finish same day. Even if you’re tired. Even if there’s a cupcake in the breakroom. Trust me, future-you will thank you. Progress Notes: Your Practice’s Revenue GPS Ultimately, that progress note is more than just a check-the-box chore. It’s a map of your care. It’s how your billers, your coders, your auditors, and your future self understand what happened in that room. When done right, it’s also a fast pass to proper payment. When done wrong—or not done at all—it’s a one-way ticket to reimbursement hell. So yes, go ahead and roll your eyes at documentation fatigue. We all do. But don’t skip it. Don't skimp on it. And for the love of your RVUs, don’t put it off until Friday. Final Thoughts (And A Gentle Nudge) Chart like your paycheck depends on it—because it does. Want to streamline documentation and speed up your billing cycle? Consider partnering with tech-forward EHRs like Azalea Health and a knowledgeable RCM team like Sunrise Services. We help make sure that your progress note gets turned into clean claims and real revenue—without the burnout. Now go finish that note. No, seriously—go. 
healthcare administration
May 6, 2025
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By 7131632906 May 5, 2025
Unspecified ICD-10 codes might seem like a harmless shortcut, but they can wreak havoc on reimbursement, audits, and your reputation as a medical coder. In this post, we explore why specificity matters in coding—and how avoiding vague diagnoses can save you time, stress, and denials. It's informative, it's a little funny, and it might just make you double-check that next R10.9.
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