2026 medical billing and coding updates: What you need to know about new ICD-10-CM and CPT codes

The fourth quarter is always a busy time for medical practices as they ramp up revenue optimization efforts and embrace new medical billing and coding updates. This year, there are plenty of changes to note. More specifically, there are 288 new CPT procedure codes (as well as 84 deletions and 46 revisions) effective January 1, 2026 and 487 new ICD-10-CM diagnosis codes (as well as 28 deletions and 38 revisions) effective October 1, 2025. Of course, it’s not possible to cover all medical billing and coding updates in this article and many of the changes may be specialty specific. That’s why it's important to scan the medical billing and coding updates in their entirety, noting which ones are likely to apply to your patient population.

To view the complete list of CPT changes, you’ll need a 2026 CPT coding manual. You can also learn more by checking out the most recent meeting minutes and recommendations from the RVS update committee as well as the most recent CPT editorial panel summary of panel actions.

To view the ICD-10-CM changes, refer to the following tables in the FY 2026 IPPS Final Rule:

• Table 6A (new ICD-10-CM codes)
• Table 6E (revised ICD-10-CM codes)
• Table 6C (invalid/deleted ICD-10-CM codes)

In the meantime, here are some highlights from the 2026 medical billing and coding updates.

1. Radiology/interventional radiology will see a comprehensive overhaul of CPT codes. Medical billing and coding updates relate to lower extremity revascularization codes and other vascular/interventional imaging codes.

2. Proprietary lab analyses account for more than a quarter (27%) of new codes. New proprietary lab analyses codes for advanced lab tests spanning multiple specialties will require updated code lists to avoid payer rejections and denials.

3. Multiple specialties will see medical billing and coding updates for artificial intelligence services that augment physician capabilities and improve patient care. These include the following:

• Cardiology: There are new CPT codes for coronary atherosclerotic plaque assessment, perivascular fat analysis for cardiac risk, and detection of cardiac dysfunction, all using innovative technology to help physicians detect clinically relevant data that might otherwise go unnoticed. (Note: Be sure to check out our cardiology coding guide as you implement these changes.)
• Burn care specialists: There is a new CPT code for assistive algorithmic classification of burn healing (i.e., healing or nonhealing) by noninvasive multispectral imaging.
• Neurologists: There is a new CPT code for augmentative algorithmic analysis of encephalographic waveforms and another new CPT code for connectomic analysis of the brain.

4. Audiologists will see several medical billing and coding updates to capture the professional services audiologists provide for hearing aids and related devices. More specifically, these codes describe the complexity and breadth of audiologic services for hearing aid candidacy determination, hearing aid selection, hearing aid fitting, follow-up after fitting, hearing aid verification, and the fitting of assistive devices.

5. Oncologists can now bill for mechanical scalp cooling services. Three new CPT codes allow oncologists to provide and bill for this service that may reduce hair loss caused by chemotherapy. (Note: Be sure to check out our oncology medical billing and coding guide heading into 2026.)

6. Providers can bill for shorter-duration remote patient monitoring (RPM). The 2026 medical billing and coding updates include a new CPT code for 2-15 days of RPM within a 30-day period as well as a new code for 10-20 minutes of RPM per calendar month, down from the previous 20-minute threshold.

7. There are new codes for immunization counseling. Providers can bill for vaccine counseling in the absence of a corresponding vaccine administration.

8. There’s a new CPT code for the flu/COVID combination vaccine. It’s an add on code to report the administration of flu vaccine within a COVID/flu combination vaccine.

9. Several new ICD-10-CM diagnosis codes in the 2026 medical billing and coding updates add greater specificity for injuries and poisonings. Examples include new codes for contusions, lacerations, puncture wounds, and open bites as well as new codes for poisoning by, adverse effect of, and underdosing of fluoroquinolone antibiotics; toxic effect of xylazine; anaphylactic reactions due to food; and other adverse food reactions.

10. There’s a new ICD-10-CM diagnosis code for Gulf War illness. This is a diagnosis the U.S Department of Veterans Affairs describes as “a cluster of medically unexplained chronic symptoms that can include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems” affecting Gulf War veterans.

11. There’s a new ICD-10-CM diagnosis codes for non-pressure chronic ulcers add greater specificity. Pay attention to anatomical location, depth, staging, and laterality.

12. There’s a new ICD-10-CM diagnosis code for Type 2 diabetes. Report it for type 2 diabetes mellitus without complications in remission.

13. There’s a new ICD-10-CM diagnosis code for cannabis hyperemesis syndrome. Report it for this condition that involves vomiting and nausea in long-term cannabis users.

14. There’s a new ICD-10-CM diagnosis code for financial insecurity. Report it specifically for difficulty paying for utilities.

15. Several new ICD-10-CM diagnosis codes in the medical billing and coding updates denote genetic susceptibility to disease. For example, new code Z15.05 denotes genetic susceptibility to malignant neoplasm of fallopian tube. Z15.060 denotes genetic susceptibility to colon cancer.

Note: All the chapters in ICD-10-CM include some degree of medical billing and coding updates except for Chapters 8 (Diseases of the ear and mastoid process, H60-H95) and 22 (Codes for special purposes, U00-U85).

How to prepare for the changes🔗

Here are three simple steps to ensure revenue integrity as medical billing and coding updates occur:

1. Provide coder and physician education. Physicians need to understand how documentation must change to reflect added specificity, and coders need to know when and how to report the most specific codes.
2. Update documentation templates and code lists in the EMR to reflect the 2026 medical billing and coding updates.
3. Monitor potential spikes in payer denials in the wake of the 2026 medical billing and coding updates.
   

Leveraging the right technology helps medical practices navigate these changes with greater ease. Learn how Medusind can help.