Annual ICD-10-CM update includes new diabetes code

Hundreds of new diagnosis codes took effect Oct. 1, 2025, as part of the annual ICD-10 update, including many that are useful in family medicine. 

The most relevant may be E11.A for reporting type 2 diabetes without complications in remission. This code is for patients who have a documented history of type 2 diabetes using standard criteria (e.g., A1C at or above 6.5%), but have achieved remission by keeping their A1C below 6.5% for at least three consecutive months without taking any diabetes medication.

When you report E11.A, your documentation must include the word "remission" and some explanation of how remission was achieved (e.g., lifestyle changes such as diet and exercise leading to documented weight loss, bariatric surgery, a supervised weight loss program, or some combination of such interventions). You should also include the patient's recent A1C readings that show remission and note that the patient has no currently prescribed diabetes medications and no ongoing diabetic complications.

E11.A is not appropriate for patients with type 1 diabetes (regardless of A1C readings) or any diabetic complication. If the patient continues to have any complication due to diabetes, instead report a code for type 2 diabetes that specifies the type of complication. Note that the ICD-10 guidelines state that terms such as “resolved” are not sufficient to state the patient is in remission, and E11.A should not be used in that situation. Instead, assign code Z86.39 (Personal history of other endocrine, nutritional, and metabolic disease) for resolved diabetes.

Other new or revised codes of interest to family physicians include the following (note that many of them require additional digits to be billable):

Abnormal rheumatoid factor and other abnormal immunologic findings in serum

• M05.A Abnormal rheumatoid factor and anti-citrullinated protein antibody with rheumatoid arthritis
• R76.81 Abnormal rheumatoid factor and anti-citrullinated protein antibody without rheumatoid arthritis
• R76.89 Other specified abnormal immunological findings in serum

Abscess, furuncle, or cellulitis of back or flank

• L02.212 Cutaneous abscess of back [any part, except buttock and flank] (revised to exclude flank)
• L02.217 Cutaneous abscess of flank
• L02.222 Furuncle of back [any part, except buttock and flank] (revised to exclude flank)
• L02.227 Furuncle of flank
• L03.31A Cellulitis of flank
• L03.32A Acute lymphangitis of flank

Apraxia

• G31.87 Primary progressive apraxia of speech

Cannabis hyperemesis syndrome

• R11.16 Cannabis hyperemesis syndrome

Contusion

• S30.11 Contusion of abdominal wall
• S30.12 Contusion of groin
• S30.13 Contusion of flank (latus) region

Costovertebral angle tenderness

• R39.851 Costovertebral (angle) tenderness, right side
• R39.852 Costovertebral (angle) tenderness, left side
• R39.853 Costovertebral (angle) tenderness, bilateral
• R39.859 Costovertebral (angle) tenderness, unspecified side

External cause or activity at time of injury or illness

• W45.3 Fishing hook entering through skin
• Y93.L1 Activity, splitting wood
• Y93.L9 Activity, other outdoor activity

Familial hypercholesterolemia

• E78.010 Homozygous familial hypercholesterolemia [HoFH]
• E78.011 Heterozygous familial hypercholesterolemia [HeFH]
• E78.019 Familial hypercholesterolemia, unspecified

Financial insecurity

• Z59.861 Financial insecurity, difficulty paying for utilities
• Z59.868 Other specified financial insecurity
• Z59.869 Financial insecurity, unspecified

Flank injury – superficial

• S30.81A Abrasion of flank
• S30.82A Blister (nonthermal) of flank
• S30.84A External constriction of flank
• S30.85A Superficial foreign body of flank
• S30.86A Insect bite (nonvenomous) of flank
• S30.87A Other superficial bite of flank

Flank pain or tenderness

• R10.8A1 Right flank tenderness
• R10.8A2 Left flank tenderness
• R10.8A3 Suprapubic tenderness
• R10.A1 Flank pain, right side
• R10.A2 Flank pain, left side
• R10.A3 Flank pain, bilateral

Genetic susceptibility

• Z15.05 Genetic susceptibility to malignant neoplasm of fallopian tube(s)
• Z15.060 Genetic susceptibility to colorectal cancer
• Z15.068 Genetic susceptibility to other malignant neoplasm of digestive system
• Z15.07 Genetic susceptibility to malignant neoplasm of urinary tract
• Z15.3 Genetic susceptibility to kidney disease

History of exposure to diethylstilbestrol

• Z91.B Personal risk factor of exposure to diethylstilbestrol (son or daughter who was exposed in utero)
• Z84.A Family history of exposure to diethylstilbestrol (child of the person who was exposed in utero)

History of malignant neoplasm of fallopian tube(s)

• Z80.44 Family history of malignant neoplasm of fallopian tube(s)
• Z85.4A Personal history of malignant neoplasm of fallopian tube(s)

Pain – pelvic and perineal, suprapubic, or multiple sites of abdomen

• R10.21 Pelvic and perineal pain right side
• R10.22 Pelvic and perineal pain left side
• R10.23 Pelvic and perineal pain bilateral
• R10.24 Suprapubic pain
• R10.85 Abdominal pain of multiple sites

— Andy Marso, FPM senior editor, and Cindy Hughes, CPC, CFPC, independent consulting editor

Posted on Oct. 6, 2025