However. Let’s talk about what’s going on now. I CD 10 for 2026. What has happened? As they do every single year. October 1st, there’s some new codes.
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Greetings to all my friends and colleagues. This is Sam Collins, the coding and billing expert for acupuncture for you, your practice, and of course for the American Acupuncture Council. Always wanna make sure that you’re getting paid correctly and to the fullest extent. To make sure that’s gonna happen.
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What is gonna happen coming up? Here’s a riddle. When do the 2026 diagnosis begin? When do they start? You may be thinking 2026 Sam. Not so fast my friends, the 2026 diagnosis codes will update October 1st. So let’s go to the slides. Let’s talk about what’s going on, obviously, and I hope that you’re aware that diagnosis codes, when they update and they update yearly, always update on October 1st.
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In fact, right now is the 10 year anniversary of ICD 10, and so it’s exciting to think wow. It’s been 10 years, so I want everyone to recall. Remember when ICD 10 came, I CD 10 came about and people lost their mind thinking, what the world’s gonna go off? No, it was all fine. In fact, for acupuncturists, I’m excited because you are going to be getting something called ICD 11.
I’m hoping it’s implemented sooner than later because there’s gonna be specific coding directly for acupuncture providers. Are traditional medicine in their descriptions, so it means you’ll be able to code cheese, stagnations, different types of patterns and all other things related to traditional medicine, which just gives a little more granularity of severity.
We’re not there yet, but we’re getting close, so pay attention next year’s seminars. I will deal with that. However. Let’s talk about what’s going on now. I CD 10 for 2026. What has happened? As they do every single year. October 1st, there’s some new codes. This year is no different. In fact, there are now 74,719 diagnosis codes.
And you may think, oh my God, that’s a lot of codes. Are you ever gonna use those, all those codes? Of course not, no. DR. Will, however, realize, keep in mind, we do need to make sure if there’s changes, are there specific to codes we use By example, this year it’s a lot of new codes, 487 new codes. 28 codes were deleted and then 38 revisions, and you’re thinking, Ooh, let’s be careful.
I’m always going to be for you and for our profession, very acentric, I care about the things that are specific to what we do. So by example, let me show you just a little bit of a list of all the codes that have updated and you’ll see here, whoa, malignant inflammatory neoplasm of the breast. And of course these are codes.
You look at this and go Sam I don’t think I’d ever use those. And I would say, you’re probably correct. You can see here primary apraxia of speech, multiple sclerosis. Now, a patient with multiple sclerosis may indeed. Be a patient of yours, but are you treating the multiple sclerosis or treating the symptoms?
Multiple sclerosis would likely just be the comorbidity. So let’s get into what are we doing that is specific to what you do. Now, here’s an important code like last year. Remember if you look at, there were some new codes for disc for the lumbar spine, though they were important. I bet. How many of you used any of those codes this year?
Probably none, but these are some, I think you might. Some of you are probably in likely coding pain codes, specifically pelvic or peroneal pain. The old code is R 10.2, but let me be careful when I say old code. That means as of October 1st, so by example, if you’re treating someone in September or before for pelvic or peroneal pain, you will continue to code R 10.2 for any date of service that was in September or earlier.
Once the data service is after October 1st, then you may begin using the new codes and here they are. So the new codes just get a little bit more specificity. Of course, there’s just the generic unspecified, which is fine, but my hope is when someone has pelvic or peroneal pain, you can identify what part of the pelvis is it?
Is it on the right side? On the left side, is it on both sides or is it more in the pubic area? This allows you to have more specificity and realize pain is gonna be one of the more common things you’re paid for. Certainly this is gonna be one that you add into your arsenal. In addition, there was some deletions of other codes or a deletion of a code here.
Also, the contusion of an abdominal wall. And you might think come on Sam I’m not gonna deal with that. You might, particularly for those of you who deal with personal injury claims, it’s very common. To have injuries to the abdomen from the seatbelt. So now we’re gonna have three new codes, contusion of the abdominal wall.
Then more specifically to the groin and to the flank. So it allows you like if the seatbelt’s going lower across the chest. Now I do wanna highlight, I hope you’re all noticing, I’m only using the A designation for this sprain strain or contusion code that A is indicating the initial visit. And it also indicates all visits with active care, which means that’s the one you’re commonly gonna use.
However, let’s say someone had a contusion and it’s six months old. That’s when you would use the S or the sequelae where there’s residuals. I think the important thing here is just making sure if you have been, or thinking you may be using contusion based on trauma, it’s updated when it comes to abdominal.
Another update here is again, some common pain codes for abdominal pain. Now, there is a code still you can save from multiple sites, and they’ve always had the quadrants, but now they’re getting more to flank and it’s not pain. Notice it’s going to be tenderness. Part of it, but then you’ll notice there’s also codes specific to pain.
So what’s the difference? Tenderness means that upon palpation, it’s tender. Where is pain is whether you palpate or not. There’s pain. I’ve put a little chart here too of what each of those mean, but the point will be if you’re using codes for abdominal pain, there has been some updates. So make sure you update your list.
This is again, those ones for the contusion. Make sure you’ve updated those again, contusions happen. And keep in mind, there’s some other ones. You’re gonna go well. Sam, I don’t know if I use this one. I doubt it. And here’s my point. Sometimes codes update of varus deformity or myositis. O Ossific hands.
Think of it. If someone has myositis o ossific hands in the upper shoulder, which means that’s the bone. What’s gonna be their symptom pain in the upper arm? So that’s probably the more likely code. The same would apply with cost of vertebral tenderness. If someone has cost of vertebral tenderness, that’s a symptom.
What is that probably gonna mean? Cost of vertebral is part of thoracic spine. I would argue that’s gonna be M 54 6. So keep in mind, it’s always nothing wrong with being specific to your profession because by example, I brought up the one for multiple sclerosis already. But are we gonna treat that directly?
There is a bunch of new codes. Are those gonna be ones you commonly use? I do not think so. So what I’m gonna say is just be conscientious of diagnosis, severity, specificity. Don’t throw spaghetti at the wall and do all types of codes. One of the things that I focus on at our seminars and with my network members is making sure you’re using the codes that are payable by insurance.
So network members expect from me, you’re gonna get a nice list because the best practice of coding. Is always gonna be giving me something about the pain, the symptoms, the signs, and there’s other codes that have within that. But what do each one pay? Get that list. That’s one for Aetna, for Cigna, what I’m gonna say is.
Let me be your advocate. Help me help you. We not only do programs like this for you that don’t cost anything, but we also do tons of seminars and other one-on-one with you to make sure your office is up to date. Again, network members expect from me, you’re getting your email with all the updates for everyone else.
I hope you be part. In fact, if you look coming this Saturday, or excuse me, Sunday for acupuncture, we’ll be doing a whole coding and update seminar. But until then, fr friends, I wish you well and see you next time.