2026 ICD-10-PCS Updates Add 156 New Codes and Delete 27 Existing Codes
2026 ICD-10-PCS Updates Add 156 New Codes and Delete 27 Existing Codes
The 2026 ICD-10-CM/PCS files have been released, including a comprehensive addendum for each system. These codes are for discharges and patient encounters occurring from October 1, 2025, to September 30, 2026. The 2026 official ICD-10-PCS guidelines were included, and the 2026 official ICD-10-CM guidelines will be released at a later date.
The diagnosis codes that were listed in the 2026 IPPS Proposed Rule are included in the addendum. As with the ICD-10-CM guidelines, the POA Exempt Code list is not yet available. However, the addendum provides information about more than 400 new diagnosis codes, along with editorial changes, added and revised notes, and other updates.
2026 ICD-10-PCS Updates
The 2026 ICD-10-PCS updates include the 14 codes that were listed in the Proposed Rule, along with additional codes approved after the March 2025 Coordination and Maintenance Update. With the addition of 156 new codes and the deletion of 27, the total number of codes in the 2026 ICD-10-PCS code set is 79,115. The guidelines remain unchanged, other than revising examples in the New Technology guidelines E1. and E1.b.
The addendum includes separate files for the Definitions, Index, and Tables. New codes are built from the updated tables. Below is a synopsis of the changes. Details of the latest codes will be explained in the 2026 ICD-10-PCS Updates presentation from YES HIM Consulting.
Medical and Surgical Section
The 00H table includes an additional qualifier for “Temporary” in the Brain body part. This will allow coding of the Insertion of a temporary infusion device for drug delivery.
Twelve new codes are available in the 00P and 00W tables for Removal and Revision of devices in the Dura or Spinal Meninges should they need to be removed or adjusted due to infection or other circumstances.
The use of Endovascular Anchor Devices in endovascular repair of thoracic and abdominal aortic aneurysms is available in the 02U and 04U tables for Supplement of these body parts. Five new codes are available in the 031 table for Bypass of the innominate artery to an upper artery, to allow coding of this portion of a thoracic endovascular aortic repair.
A new code table, 09X, has been created for coding the Transfer of vascularized nasal tissue used to reconstruct skull base defects. Six new codes are reportable in the new 0C1 table for Bypass of the larynx in procedures such as cricothyrotomy. Creation of an endoscopic choledochoduodenostomy is now reportable via two new codes in the 0F1 table for Bypass of the Common Bile Duct to the Duodenum.
There are new qualifiers in both code tables for Replacement of the Upper and Lower Joints. In the 0RR table, a qualifier for subscapularis-sparing technique is available to report this technique for shoulder replacement. In the 0SR table, eight new codes are available using the qualifier values for Medial and Lateral Meniscus with an Autologous or Nonautologous Tissue Substitute.
Medical and Surgical Related and Ancillary Sections
The Extracorporeal or Systemic Assistance and Performance has five new Assistance codes for Intraoperative Cerebral Embolic Filtration devices in table 50A. These devices capture and remove debris that may be dislodged during interventional procedures. These codes were created after four New Technology X codes were deleted.
A new code for the use of a protective insulation device for a donor kidney graft being transplanted is created in the 6A4 table for Extracorporeal or Systemic Therapies, Hypothermia. In the Other Procedures section, a new code is created in the 8E0 table to represent real-time imaging for intraoperative evaluation of excised tissue using a confocal microscopy system.
Finally, in the Ancillary section table F08, new Wound Management codes are available to represent Negative Pressure Therapy for acute and chronic wounds, with body part/region values for areas of the integumentary and musculoskeletal systems.
New Technology Section
Nearly 100 new codes are found in the New Technology Section X codes. As always, these codes are meant to be temporary and represent emerging procedures and services. The codes all begin with the letter X, and the 2026 codes end in character B for New Technology Group 11.
The codes may be quite specific to a particular device. For example, new code X053X4B is reported for Sonodynamic therapy (SDT), a focused ultrasound therapy used for the brain to ablate targeted cancer tissue. Code X2HN37B is reported for the Insertion of a WiSE Cardiac Resynchronization Therapy (CRT) System, a leadless system that delivers left ventricular endocardial pacing going to the heart. New code XDJ07LB is available for the use of the PillSense system, an ingestive device that uses light absorption technology to inspect the gastrointestinal system to detect bleeding.
Codes are available for the Introduction of substances that are in new use. For example, code XW013TB is available for subcutaneous administration of a substance, generic name RYSTIGGO, used to treat a particular subtype of patients with myasthenia gravis. Two codes are available for the peripheral or central vein Transfusion of Roctavian™ for treatment of severe hemophilia A.
Applications for New Technology Add-on Payments (NTAP) have been submitted for many of the new X codes to reimburse for these new devices, drugs, and services. If approved, an additional NTAP payment will be made, as the costs associated with the codes have not yet been incorporated into the MS-DRG payment. Reimbursement levels vary from nominal to substantial payments based on the cost of providing the service represented by the X code. Decisions on the 2026 NTAP applications are published in the Final Rule for the Inpatient Prospective Payment System along with any applicable payment amount.
A comprehensive review of all changes in the New Technology System and NTAP information will be incorporated into a separate presentation from YES HIM Consulting, along with the presentation on the 2026 ICD-10-PCS changes to the Medical and Surgical, Medical and Surgical Related, and Ancillary section codes.
For more information on the ICD-10 updates, review our ICD-10 Coding Resource Center.
