The ICD-10-CM and PCS codes were published in June 2024. When ICD-10 codes are published, files are posted on the Centers for Medicare and Medicaid (CMS) website. The files are separated by diagnosis (ICD-10-CM) and inpatient treatment (ICD-10-PCS). The ICD-10 codes are published semi-annually.
For the diagnosis codes, the files include index, table, drug, external index, neoplasm, and order files. Each file also has a corresponding appendix that contains only the changes for fiscal year 2025 (for this year).
The index is the alphabetical listing of diagnoses with the corresponding codes.
The Tabular is the volume in which the diagnosis codes are listed in alphanumeric order. This volume also contains coding instructions for each chapter, category, subcategory, code, etc.
In the medication file, the medications/substances are listed along with the type of poisoning (accidental, intentional self-harm, bodily harm, unclear), side effects and underdosage.
The External Cause Index is the alphabetical listing of external causes of injury. The Neoplasm Table lists the anatomical sites of neoplasms according to behavior – primary malignant, secondary malignant, carcinoma in situ, benign, uncertain behavior, and unspecified behavior.
The order file is usually used by programmers or software developers because it contains categories, subcategories and codes. In other words, it lists valid and invalid codes.
The ICD-10-CM guidelines have been updated for October 2024. Changes in the guidelines are indicated by bold (narrative\changes), underlining (movement within the guidelines), and italics (revisions of heading changes).
The ICD-10 PCS Code Update includes Definition Addenda, Table Addenda, PCS Update Summary, and PCS. The Definition Addenda includes changes to PCS characters 3 through 7. The key provides guidance for specific body parts, substances, root operations, and the corresponding value in the code set. The Table Addenda only includes the changes in the PCS tables. The changed table rows are identified. The specific change is not noted.
The PCS Update Summary provides a quick overview of the overall changes, changes to the guidelines, and a list of associated files. This document also includes a listing of each section and the total number of codes now in that section. The PCS file contains the index and tables for ICD-10-PCS. This file is like an electronic version of the ICD-10-PCS codebook.
The ICD-10-PCS guidelines are also updated regularly. There were no updates to the guidelines for FY25, but a version for FY25 was included in the files.
The ICD-10-CM and ICD-10-PCS files are freely available resources.
It is important for programmers to understand how classification works without encoders. These resources are wonderful for practicing classifications without spending any money.
The 2025 financial year is just around the corner!
Resources:
ICD-10-CM FY25: https://www.cms.gov/medicare/coding-billing/icd-10-codes/2025-icd-10-cm
ICD-10-PCS FY25: https://www.cms.gov/medicare/coding-billing/icd-10-codes/2025-icd-10-pcs
