Changes in ICD-10-CM, CPT, and HCPCS from 2024 to 2025
ICD-10-CM Changes
There were significant changes in the ICD-10-CM Official Guidelines for Coding and Reporting from 2024 to 2025, effective October 1, 2024. These updates encompass the introduction of new codes, deletions, and revisions to existing codes to enhance specificity and accuracy in medical documentation.
Key Updates Include:
Lymphoma Remission Status: Sixty-three new codes have been added to specify lymphoma in both active and remission stages, allowing for precise identification and improved tracking of patient outcomes.
Personal History of Polyps: Four new codes have been introduced to differentiate between non-neoplastic and neoplastic polyps, aiding in accurate risk assessment and management.
Obesity Due to Disruption of Melanocortin 4 Receptor (MC4R) Pathway: New codes have been added to document obesity resulting from specific genetic disruptions, reflecting advancements in understanding obesity's etiology.
Specific Types of Eating Disorders: The guidelines now include codes for distinct eating disorders, facilitating better diagnosis and treatment planning.
Cement and Fat Pulmonary Artery Embolisms: New codes have been established to identify these specific types of embolisms, improving clinical documentation and patient care strategies.
Anal and Rectal Fistulas: Additional codes have been incorporated to describe various types of anal and rectal fistulas, enhancing the precision of surgical and treatment records.
Alopecia: The guidelines now offer more detailed codes for different forms of alopecia, supporting targeted treatment approaches.
New Z Codes: Several Z codes have been added to capture factors influencing health status and contact with health services, ensuring comprehensive patient records.
CPT Changes
“There are 420 overall updates in the CPT 2025 code set, including 270 new codes, 112 deletions, and 38 revisions.” per AMA.
Key Updates Include:
Digital Medicine:
Revisions to remote therapeutic monitoring (RTM) services:
Code 98975 now includes digital therapeutic intervention.
Codes 98976-98978 have been updated to encompass device supply for data access or transmissions supporting RTM.
Artificial Intelligence (AI) Taxonomy:
The AI taxonomy introduced in 2023 has been applied to Category III CPT codes, classifying AI medical services as assistive, augmentative, or autonomous, based on the AI application's role in supporting healthcare professionals.
Telemedicine and Evaluation & Management (E/M):
A new section of E/M codes includes 17 options for reporting audio/video services for new and established patients. Additionally, specific codes have been created for audio-only consultations.
Category III Codes:
Significant updates with 81 new codes, 2 revisions, and 13 deletions to capture emerging procedures, services, technologies, and service paradigms.
HCPCS Changes
HCPCS codes are periodically updated throughout the year. For example, the April 2025 HCPCS Quarterly Update introduced additional changes, including new codes like J1938 for injection of furosemide, 1 mg, and J2351 for injection of ocrelizumab, 1 mg and hyaluronidase-ocsq.
Key Updates Include:
New Codes: Several HCPCS codes have been introduced to describe new medical procedures and services. For instance, J1072 denotes an injection of testosterone cypionate (azmiro), 1 mg.
Revised Codes: Some existing codes have undergone modifications to their descriptions or usage guidelines to enhance clarity and accuracy. Specific details on these revisions can be found in the official HCPCS update documents.
Discontinued Codes: Certain codes have been retired and are no longer valid for billing purposes as of January 1, 2025. Healthcare providers should ensure they are not using these obsolete codes in their documentation and billing processes.
Stay informed! Regularly consult official sources, such as the Centers for Medicare & Medicaid Services (CMS), for the latest HCPCS updates.
