2025 ICD 10 PCS Changes and CM Addenda: New Codes Effective April 1

2025 ICD 10 PCS Changes and CM Addenda: New Codes Effective April 1

April 1 is now an official time for updates to the ICD-10 system, and the 2025 ICD 10 PCS changes bring 50 new procedure codes. While there are no new diagnosis codes, an addendum with minor changes was made available.

Key Updates in 2025 ICD 10 PCS Changes

There are 50 new ICD-10-PCS codes, the majority of which are in the New Technology section. Also included are several new codes in the Medical and Surgical section as well as additions in Obstetrics and Administration sections and one Radiation Therapy code. View the April 1, 2025, addendum.

Medical and Surgical Section

The 2025 ICD-10-PCS changes include one new code in code table 0B1, Respiratory System Bypass adding approach value 8, via natural or endoscopic approach, endoscopic for the body part Trachea and the qualifier Esophagus to facilitate coding of endoscopic tracheoesophageal puncture (TEP) to create a path for air to move from the lungs to the esophagus after a total laryngectomy.

There is a new code table, 0CY, Mouth and Throat Transplantation, allowing for the building of two codes representing larynx transplants, an emerging procedure for patients with laryngeal dysfunction or laryngectomy.

Two new codes in the 0DX table, Gastrointestinal Transfer, are formed by adding the qualifier value 7 for the vagina to allow for coding procedures such as ileal interposition vaginoplasty for reconstructive treatment of various anomalies.

Six new codes are available in the 0TT table, Urinary System Resection, by adding qualifier values for allogeneic, syngeneic, and zooplastic and allow for coding of a transplantectomy or resection of a transplanted right or left kidney.

One new code in the 0U7 table, Female Genital System Dilation, with the body part Cervix and qualifier Temporary, is added for the row that includes a 6th character for Intraluminal device. These devices are used to dilate the cervix and remain for up to a few hours to a maximum of 24 hours.

Obstetrics Section

In the Obstetrics section, the approach value 0 for open is added to the 10D table, Pregnancy Extraction and body part Products of Conception, Retained to allow for removal of these retained products of conception using an open approach when an approach via the vagina is not possible.

Administration Section

One new ICD-10-PCS code is added in the 3E0 table Administration Introduction under the body part U for joints, qualifier C for other substances. This will allow for procedures such as the use of bone graft material in open ankle joint procedures.

Radiation Therapy

The addition of new code table, D22 Heart and Great Vessels Stereotactic Radiosurgery, resulted in one new Radiation Therapy code, D228DZZ, for Stereotactic photon radiosurgery of conduction mechanism.

New Technology Section X Code Additions

The New Technology, or X codes, account for the remaining new 2025 ICD-10-PCS codes. All these codes will have an A as the 7th character to indicate new technology group 10. The updates include:

• One new code is in the Cardiovascular Bypass X2K table from the addition of a row for the body part A for left atrium and 6th character value 0 for conduit through coronary sinus to right atrium. This allows for the coding of the APTURE Transcatheter Shunt System for treatment of heart failure.
• A new device value, Y, for Heterotopic Bioprosthetic Valve(s) is added to code table X2U Cardiovascular Supplement for the right atrium body part. This allows for the coding of the TricValve® Transcatheter Bicaval Valve System for the treatment of severe tricuspid regurgitation via one new code.
• Twenty-eight new codes are added in the XNS table for Bones Reposition, by adding the device value G, Ring External Fixation Device with Automated Strut Adjustment. This allows coding for the use of a hexapod ring fixator, a type of external fixation device that can be adjusted to apply force to move bone fragments internally during the healing process. Codes are available for the body parts right and left humeral shaft, radius, ulna, upper and lower femur, femoral shaft and tibia with either an open or percutaneous approach.
• Four new codes are added to the XW0 table for Introduction of two substances into peripheral or central veins. The first, emapalumab-lzsg,(GAMIFANT™), is used in the treatment of hemophagocytic lymphohistiocytosis (HLH), a rare and frequently fatal hyperinflammatory syndrome. The second is for tarlatamab-dlle, (IMDELLTRA™), used for adult patients with extensive stage small cell lung cancer (SCLC), one of the most aggressive solid tumors.
• The final code is in the XXE table Measurement with the 6th character 5 for Immune response whole blood cellular assessment via microfluidic deformability. This allows for coding of the ItelliSep device used as an aid to the early detection of sepsis in adult patients with signs and symptoms of infection who present to the Emergency Department.

Code Deletions and Title Revisions Complete the Update

The updates included 12 deleted codes from the elimination of the body part 6, coccygeal joint in the 0SG table for Lower Joint Fusion, as these codes were determined to be clinically invalid. Also, two code titles have been revised in the XW1 code table for Transfusion as the manufacturer has changed the name of the OTL-200 substance to its final name, Atidarsagene Autotemcel.

With the 50 new codes, 12 deletions, and 2 code title revisions, the ICD-10-PCS system now contains 78,986 codes.

Guidelines and Addendum

The Addendum Summary notes that there are no changes to the Guidelines for April 1, 2025. Also included are addenda for the code tables and index. The definitions addenda include one new entry for body parts and new entries for devices in the Medical and Surgical section, as well as several Section X device, substance, and technology additions.

Update to the MS-DRG Grouper

The ICD-10 MS-DRG Grouper software package to accommodate these 50 new codes, Version 42.1, is effective for discharges on or after April 1, 2025.

View the full list of the codes along with their O.R. status, MDC, and MS-DRG assignments.

No New Diagnosis Codes for April 1

The ICD-10-CM diagnosis code system did not add any new codes for April 1, 2025, but did use the update as an opportunity to post some minor corrections to the tabular and index. View this addenda.

Review our ICD-10 Coding Resource Center for additional information on the 2025 ICD 10 updates. For comprehensive training on the ICD 10 updates for 2025, view our education collection.