Annually on Oct. 1, new ICD-10 codes for diagnoses and inpatient procedures go into effect. Decided upon by the CDC and CMS earlier in the year, the new list includes additions, changes, and deletions in an ongoing effort intended to improve coverage decisions and help patients move from diagnosis to therapy with fewer delays. 

But in the short term, these changes can cause confusion for those responsible for understanding patients’ benefits and claims information.

What do these changes mean for patient support?

In 2026, the update includes 487 new diagnosis codes, 38 R-code revisions, and 28 invalidated or deleted codes. Notably, the diagnosis codes for Multiple Sclerosis have been significantly expanded, and the diagnosis code of G35 will now require a higher level of specificity.

This means claims submitted with an ICD-10 code of G35 may be denied for being out of date, potentially leading to treatment delays. In addition, in the short term, payor agents may or may not have detailed benefits information for these new, more detailed diagnosis codes.

Do these changes affect Infinitus customers?

Infinitus is working to ensure continuity without any interruption for all customers impacted by these changes, and we partner with our customers every year to handle them in whatever way best suits their needs.

We’re also actively working directly with payors to make sure their agents are aware of the changes in order to minimize downstream impacts in the revenue cycle management of these processes.

How can we better prepare for these changes next year?

Because ICD-10 codes are most often submitted initially by providers, it’s important to ensure they are up to date on these changes and that they don’t slip through the cracks. Infinitus provider-facing AI agents can help with this, educating healthcare providers on the latest information related to updates such as this, as well as anything related to your therapies.

If you have any questions about these changes and what they mean for your partnership with Infinitus, or would like to learn more about our provider-facing AI agents, speak to your account team or contact us today.