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Every October 1, CMS updates the ICD-10-CM code set. FY 2027 changes take effect October 1, 2026. Practices that aren’t prepared risk claim rejections, denials, and revenue cycle disruption. This blog breaks down what is changing and what to do before the deadline.
Key takeaways
- FY 2027 includes 190 new ICD-10-CM codes, 30 deleted codes, and four revised code descriptions, all effective for encounters beginning October 1, 2026.
- Using a deleted or invalid code after October 1 will result in a claim rejection. Diagnosis lists, templates, and EHR favorites need to be updated before the transition.
- Preparation needs to happen before October 1, not after the denials start arriving.
Every October 1, the rules change, as CMS releases annual updates to the ICD-10-CM code set. FY 2027 updates take effect October 1, 2026. For practices that aren’t prepared, the result can be claim rejections, denials, and revenue cycle disruption that takes weeks to untangle. Here’s what you need to know.
What’s New, Deleted, and Revised for FY 2027
The FY 2027 update includes 190 new ICD-10-CM codes, 30 deleted codes, and four revised code descriptions, all of which take effect for encounters beginning October 1, 2026.
| Year | New Codes | Deleted Codes | Revised Code Titles |
|---|---|---|---|
| FY 2027 | 190 | 30 | 4 |
| FY 2026 | 487 | 28 | 38 |
What Providers Need to Know About the New Code Set
ICD-10 updates can affect more than just your billing team. Understanding the types of changes and what each one requires helps the entire care team stay ahead of the transition.
New codes
A more specific diagnosis code may now be available for a condition your providers already treat.
Deleted codes
A code that was valid before October 1 may no longer be billable after that date. Using a deleted code after the effective date will result in a claim rejection. Diagnosis lists, templates, and EHR favorites that contain deleted codes need to be updated before the transition.
Revised code descriptions
The code itself may not change, but its clinical meaning or definition may. Practices need to verify that their teams understand and apply these codes.
New coding guidelines
The FY 2027 update includes changes to official coding guidelines. Guideline changes can impact how diagnoses should be documented and assigned even when the codes themselves haven’t changed.
National Coverage Determination updates
CMS’s October 2026 NCD update also includes new and deleted ICD-10 diagnosis codes associated with National Coverage Determinations. CMS has explicitly instructed providers to ensure their billing staff is aware of these changes, because using a diagnosis code that no longer satisfies a coverage determination can result in a denied claim even when the service itself is covered.
The Revenue Cycle Impact of ICD-10 Updates
ICD-10 updates pose several distinct risks to the revenue cycle, and most are preventable with the right preparation.
Claim rejections from deleted codes
Any claim submitted on or after October 1 that includes a deleted or invalid code will be rejected at the payer level. Reducing denials before submission starts with making sure your code set is current and that deleted codes have been removed from all active diagnosis lists, templates, and order sets.
Documentation gaps for new codes
New codes that require greater clinical specificity cannot simply be plugged into a claim. If the provider’s note does not support the specificity the new code requires, the claim will not hold up.
System and workflow misalignment
The code changes need to be reflected everywhere they touch: EHR diagnosis lists, billing system code files, claim edit rules, order templates, and any other workflow that references ICD-10 codes. For multi-specialty practices managing this complexity across multiple departments, coordinated RCM strategies become especially important during a code update transition.
How to Get Your ICD-10 Workflows Ready
The window for preparation is now, and the most important thing practices can do is start before the denials give you a reason to.
The first step is reviewing the full list of new, deleted, and revised codes and identifying which ones apply to your patient population and specialty mix. From there, EHR diagnosis lists, order sets, and billing templates need to be updated to remove deleted codes and add new ones.
Provider communication is just as important as system updates. New codes and their documentation requirements need to reach clinical staff before the effective date, not after the first wave of rejections. Billing staff also need to be briefed specifically on NCD-related code changes and which coverage determinations are affected, since those changes carry their own denial risk that is separate from standard code validity issues.
Finally, billing system code files and claim edit rules need to reflect the updated code set.
RXNT’s practice management platform supports the integrated workflows that make transitions like this more manageable, keeping clinical documentation, coding, and billing connected so that code set updates do not create gaps between what providers document and what billing teams submit.
FAQs
When do the FY 2027 ICD-10-CM changes take effect?
The FY 2027 ICD-10-CM code set takes effect for patient encounters beginning October 1, 2026.
How many new ICD-10-CM codes are there for FY 2027?
The FY 2027 update includes 190 new ICD-10-CM codes, along with 30 deleted codes and four revised code descriptions.
How can practices prepare for the 2027 ICD-10 update?
Practices should review applicable code changes, update EHR and billing systems, communicate documentation requirements to providers, and ensure billing teams understand relevant coverage changes before October 1.
