The fiscal year 2027 ICD-10-CM update adds 190 new diagnosis codes, deletes 30, and revises 4, effective October 1, 2026, according to the Association of Clinical Documentation Integrity Specialists (ACDIS). The matching ICD-10-PCS procedure code update adds 101 new codes, deletes 38, and revises 3, with 50 of those additions sitting in a new technology section spread across 13 tables, according to Revenue Cycle Advisor.
That diagnosis-code count is smaller than what practices handled a year ago. CMS added 487 new ICD-10-CM codes for fiscal year 2026, effective October 1, 2025, ACDIS reported at the time. The FY2027 total of 190 new codes runs 61.0% below that figure. A smaller number of additions does not shrink the task ahead of the deadline. Every practice management system, superbill, and clearinghouse edit still needs the deletions and revisions loaded before the switch, and this year's additions concentrate in a small number of specific categories rather than spreading evenly across specialties.
Where the New Diagnosis Codes Land
ACDIS's breakdown of the FY2027 release shows most of the 190 new codes cluster in a handful of categories. Pregnancy coding picks up 33 new codes in category O31.4, for pregnancy after a vanishing twin. Toxicology coding for cycloparaffin exposure, category T52.82, adds 17 new codes, and toxic-effect coding for alkenes, category T52.81, adds 16, both broken out by encounter type.
Smaller additions land in dental and orthopedic coding: 6 new codes for odontogenic sinusitis, category J34.83, split by sinus location, and 5 new codes for plantar fasciitis, category M67.A, split by foot side. Adult body-mass-index coding adds 2 new codes in the Z68.18 to Z68.19 range. The release also adds a code for history of Clostridioides difficile infection, Z86.17, and two codes for hypoglycemia following bariatric surgery, E89.830 and E89.838, according to Revenue Cycle Advisor.
| Category | New codes | What it covers |
|---|---|---|
| O31.4 | 33 | Pregnancy after vanishing twin |
| T52.82 | 17 | Toxic effect of cycloparaffins |
| T52.81 | 16 | Toxic effect of alkenes |
| J34.83 | 6 | Odontogenic sinusitis, by sinus |
| M67.A | 5 | Plantar fasciitis, by foot side |
| Z68.18-Z68.19 | 2 | Adult body mass index |
Source: ACDIS, "ICD-10-CM code set for fiscal year 2027 released," July 2, 2026.
What Changes on the Procedure Side
The ICD-10-PCS update runs on a different clock than diagnosis codes. Revenue Cycle Advisor reports the FY2027 ICD-10-PCS codes take effect October 1, 2026 through March 31, 2027, a shorter window than the ICD-10-CM set's October 1, 2026 through September 30, 2027 span, since CMS revisits procedure codes twice a year. CMS's own ICD-10 code files show smaller additions in the between-year updates: 41 new procedure codes took effect April 1, 2024, and 34 took effect April 1, 2023.
Of the 101 new procedure codes in the FY2027 release, 50 sit in the new technology section, spread across 13 tables. CMS also created a new table, XEZ, to classify 10 of those new-technology codes for procedures involving physiological systems and anatomical regions, according to Revenue Cycle Advisor. The update also deletes 38 existing ICD-10-PCS codes and revises 3. ICD-10-PCS applies to inpatient hospital procedure coding rather than physician office claims, so most of the exposure for independent practices sits with hospital-affiliated and ASC service lines rather than the office schedule itself.
A Smaller Update Than Last Year, By the Numbers
Put side by side, the FY2027 diagnosis-code release is the smaller of the two years by a wide margin. ACDIS reported 487 new ICD-10-CM codes for FY2026, effective October 1, 2025. The FY2027 release drops that to 190 new codes, a 61.0% decline, even as the count of deletions, 30, and revisions, 4, stays in the range coders have managed in prior annual updates.
| Metric | FY2026 (effective Oct. 1, 2025) | FY2027 (effective Oct. 1, 2026) |
|---|---|---|
| New ICD-10-CM codes | 487 | 190 |
| Year-over-year change | not applicable | -61.0% |
Source: ACDIS, "CMS releases FY 2026 ICD-10-CM code update," July 10, 2025, and "ICD-10-CM code set for fiscal year 2027 released," July 2, 2026.
A smaller code count changes the size of the training task, not whether it exists. Each of the 190 additions, 30 deletions, and 4 revisions has to reach the practice's EHR problem lists, encounter templates, and clearinghouse edits before the first claim goes out on or after October 1, 2026. The deletions include the entire S23.420 series of sternoclavicular sprain codes, according to ACDIS, so any orthopedic or urgent care encounter template still pointing to one of those specific codes needs a fix before the cutover, not after the first denial arrives.
What to Check Before October 1
A handful of specific actions separate practices that load the update on time from ones that find out through a denial. The checklist below ties each item back to the counts above so billing teams know how much work is actually involved.
- Confirm the EHR and practice management vendor has loaded all 190 new ICD-10-CM codes and removed the 30 deleted codes before October 1, 2026.
- Route the largest new categories to the service lines that use them: obstetrics for the 33 new O31.4 codes, toxicology and emergency coding for the 17 T52.82 and 16 T52.81 codes, dental or ENT for the 6 J34.83 codes, podiatry or orthopedics for the 5 M67.A codes, and primary care for the 2 Z68.18-Z68.19 codes.
- Check that clearinghouse edits and payer contract logic reflect the 4 revised ICD-10-CM codes and 3 revised ICD-10-PCS codes, since a revision changes what an existing code means, not just what is available.
- For ASC and hospital-affiliated service lines, confirm the ICD-10-PCS update, including the 50 new technology-section codes across 13 tables, is loaded on the same October 1, 2026 date as the diagnosis code set.
None of these checks require new staff or new software. They require someone confirming, category by category, that a vendor update actually reached the system the practice bills from, before the codes go live on October 1.
Sources
- ACDIS, "ICD-10-CM code set for fiscal year 2027 released," July 2, 2026
- Revenue Cycle Advisor, "FY 2027 ICD-10 code sets released," June 17, 2026
- ACDIS, "CMS releases FY 2026 ICD-10-CM code update," July 10, 2025
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