The ICD-10-CM code set for 2026 takes effect October 1, 2025: All members should be using the new code set for services performed on or after this date. The new code set includes 487 new code additions, 28 deletions, and 38 modifications. Some of these are pertinent to foot and ankle care, including changes involving lower extremity ulcers, diabetes, and more. APMA has produced a presentation and list of ICD-10-CM changes for members online here, including a webinar by Jeffrey D. Lehrman, DPM, CPC.
Type 2 Diabetes
The 2021 International Consensus Report defining type 2 diabetes in remission, coauthored by the ADA, EASD, Diabetes UK, the Endocrine Society, and others, defines type 2 diabetes in remission as, "a return of HbA1c to <6.5% (48mmol/mol) that persists for at least 3 months after stopping glucose lowering pharmacotherapy."
If the type 2 diabetes in remission diagnosis played a role in the management provided during an encounter, that should be reflected in the ICD-10-CM coding that accompanies the encounter. The new, complete ICD-10-CM code will be:
E11.A Type 2 diabetes mellitus without complications in remission
Shin Ulcers
Non-pressure chronic ulcers of the lower limb are represented by ICD-10-CM codes that begin with the code stem, L97- (Non-pressure chronic ulcer of lower limb, not elsewhere classified). Until October 1, 2025, the only 4th character options for this code stem are:
Previously, there was no coding option to represent a non-pressure chronic ulcer of the shin. This changes on October 1, 2025, with the introduction of a new inclusion term for L97.2-, which is "Non-pressure chronic ulcer of shin." With this change, non-pressure chronic ulcers of the shin will now be represented by the L97.2- codes.
Aggressive Fibromatosis
Aggressive fibromatosis (commonly referred to as "desmoid tumor") is an abnormal growth that can develop from muscle connective tissue and aponeuroses. It is nonmetastasizing, may demonstrate local infiltration into tissue, and typically displays a high risk of recurrence following surgical removal. This differs from typical plantar fibromatosis (Ledderhose Disease) which is typically confined to the fascia, does not involve muscle, and is not infiltrative in nature. Prior to this new code set, there was a diagnosis code representing desmoid tumor (D48.11), and effective October 1, 2025 "aggressive fibromatosis" will be added as an inclusion term under D48.11.
Multiple Sclerosis
Prior to October 1, 2025, G35 (Multiple sclerosis) was a complete code. Starting October 1, 2025, G35- will no longer be a complete code and will require additional characters. This change creates the following new codes:
Financial Insecurity
Social determinants of health often play a role in patient care. Social determinants of health can also play a role in evaluation and management level selection. In many cases, it is appropriate to represent certain social determinants of health, such as financial insecurity, in the diagnosis coding that accompanies an encounter. Prior to October 1, 2025, Z59.86 (Financial insecurity) was a complete code: Starting October 1, 2025, Z59.86 will no longer be a complete code and will require additional characters. This change creates the following new codes:
Information on all ICD-10-CM changes is available online here from CMS.