If you’ve been feeling stifled by the lack of specificity among diagnosis codes for conditions like obesity, sepsis, hypoglycemia and more, you’re in luck. CMS has released the diagnosis code updates, which will go into effect on Oct. 1, 2024, and the new ICD-10 codes for 2025 include options describing those conditions.
There are over 200 new diagnosis codes to learn, but we’ve prepared a few highlights so you can get a sneak peek of the new ICD-10 codes for 2025.
Look for 3 New Hypoglycemia Codes
Currently, your providers don’t have to include a patient’s hypoglycemia level on their claims, but in 2025, many codes will require it. For instance, if you report existing code E11.64 (Type 2 diabetes mellitus with hypoglycemia), a new note under the code states, “Use additional code for hypoglycemia level, if applicable (E16.A-).
If the E16.A series doesn’t ring a bell, that’s because these codes are brand new ICD-10 codes for 2025. The new hypoglycemia level codes are:
- E16.A1 (Hypoglycemia level 1)
- E16.A2 (Hypoglycemia level 2)
- E16.A3 (Hypoglycemia level 3)
According to comments presented at the September 2023 ICD-10-CM Coordination and Maintenance Committee meeting, documenting these levels through dedicated diagnosis codes will help improve “patient management, diabetic research, and physician decisions to order continuous glucose monitoring systems.”
Check 7 New Obesity Codes
Providers who see patients with obesity may be accustomed to using codes under the E66 section (Overweight and obesity). But that section will provide additional specificity in 2025, thanks to the addition of six new codes for obesity, as follows.
- E66.8 (Other obesity)
- E66.81 (Obesity class)
- E66.811 (Obesity, class 1)
- E66.812 (Obesity, class 2)
- E66.813 (Obesity, class 3)
- E66.89 (Other obesity not elsewhere classified)
When Dr. David Berglund and Dr. Brook Belay spoke about these codes at the March 2023 ICD-10 Coordination and Maintenance Committee meeting, they noted that adding the obesity class to the ICD-10-CM manual would allow for better patient management and would help providers more accurately identify the potential risk factors these patients face.
Bonus code: In addition, under the “Other specified metabolic disorders” section (E88.8), you’ll find a new code describing obesity due to a disruption of the MC4R pathway (E88.82). According to comments at the March 2023 meeting, there are more than 17,500 patients living with obesity caused by issues in the MC4R pathway, and this code will allow for more accurate reporting of those conditions.
Benefit From New Sepsis Code
You’ll also find a new code that describes an encounter for sepsis aftercare with the addition of Z51.A. According to comments shared at the March 2023 ICD-10 meeting, this code was established because sepsis survivors “have a high readmission risk due to post-acute complications and sequelae of sepsis after hospital discharge.” The CDC was urged to add this new code to “facilitate rehabilitation and target preventive care after hospital discharge.”
In addition, the existing code set was considered inappropriate in reflecting post-acute and community-based care situations, since the life-threatening sepsis condition is typically resolved following hospital discharge.
If you’re looking for more details about the new ICD-10 codes for 2025, look no further! Save the date for September 10, when coding expert Maya Turner, CPC, CPMA, will be sharing all the information you need about the updated diagnosis code set during an exclusive online training at 1:00PM ET. Keep the date open on your calendar—registration will be coming soon!
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The post Hypoglycemia, Obesity Among New ICD-10-CM Codes for 2025 appeared first on Healthcare Training Leader.