FY2027 ICD-10-CM: 238 Added Entries, 190 Billable Codes
Effective October 1, 2026: 238 added entries, 21 removed entries, and 15 retained codes that become headings. Review the complete tables and CMS source files.
By the HCC Buddy Coding Team
Updated: September 30, 2026
The FY2027 ICD-10-CM order file adds 238 entries: 190 billable codes and 48 non-billable headings. It removes 21 entries: 15 billable codes and 6 headings. Another 15 retained codes become non-billable headings, so 30 formerly billable codes need review. The release takes effect October 1, 2026. The largest groups of added entries are injury and poisoning (85), pregnancy and childbirth (56), and musculoskeletal conditions (33).
This is the complete list of added entries, grouped by ICD-10-CM chapter, with the removed entries below. Each table preserves the official order-file description and billable status. Use the FY2027 update reference for the full change list and source files. For prior-year context, see our FY2026 guidelines recap and the April 2026 update.
*Source: the CMS FY2027 order file, compared with the FY2026 April order file. Effective October 1, 2026. Verify the applicable encounter or discharge date and official tabular instructions before using a code.*
FY2027 ICD-10-CM changes at a glance, effective October 1, 2026
The order file grows by a net 217 entries. FY2027 contains 74,879 billable codes. The chapter counts below include headings; a heading cannot be submitted as a complete code.
The FY2027 changes that matter most for risk adjustment
What happens to I42.0 dilated cardiomyopathy on October 1, 2026?
Dilated cardiomyopathy is no longer one code. I42.0 stops being billable at the cutover and becomes a category header. You code instead to I42.00 (unspecified), I42.01 (familial-genetic), or I42.09 (other). I42.8 also becomes a header, splitting into I42.81 (arrhythmogenic cardiomyopathy) and I42.89. If your templates or problem lists carry I42.0 or I42.8, they stop validating on October 1. Check the applicable CMS mapping before assigning an HCC to a child code. The PY2027 Initial mapping does not cover these additions. For the co-morbidity context, see our heart failure HCC coding guide.
New arrhythmia and inherited cardiac codes
I49.81 (Brugada syndrome), I49.82 (ventricular bigeminy), and I47.22 (catecholaminergic polymorphic ventricular tachycardia) carve out conditions that previously fell to less specific parents. I49.8 itself becomes a non-billable header on October 1. For how arrhythmia specificity affects capture, see our atrial fibrillation HCC coding guide.
Inherited cancer predisposition gets its own block
The new QA1 category adds Lynch syndrome (QA1.71), familial cancer syndrome with BRCA1 (QA1.790) or BRCA2 (QA1.791) mutation, and Li-Fraumeni syndrome (QA1.792). Loeys-Dietz syndrome (Q87.A) and VEXAS syndrome (M04.3) also get first-time discrete codes. These conditions drive screening and surveillance, so the documentation to support them tends to be in the chart.
Gender-related history codes
Z87.8901 through Z87.8909 capture social, medical, surgical, intersex-surgery, and unspecified gender transition history, with Z87.893 for detransition and F64.A for gender identity disorder in remission.
Exposure and history Z codes
Blast overpressure (Z77.40 through Z77.49), Agent Orange (Z77.33), burn pits in a war theater (Z77.32), and gadolinium exposure (Z77.013) paired with R78.72 (abnormal gadolinium level in blood). Z86.17 adds personal history of Clostridioides difficile infection. Z68.18 (BMI 18.4 or less) and Z68.19 (BMI 18.5 to 19.9) add low-end BMI specificity that matters for malnutrition and frailty documentation.
What the published PY2027 Initial mapping covers
Reviewed September 30, 2026. The code-set and mapping files have separate scopes.
CMS has published the Payment Year 2027 Initial ICD-10-CM mappings. That file does not cover the FY2027 additions listed here. An ICD-10-CM fiscal year and an HCC payment year identify different releases. No HCC assignment or RAF value for these new codes is established by this article. See the CMS 2027 model software and mappings page.
HCC Buddy's live lookup currently serves FY2026 April. Use the FY2027 reference for these changes and check the source period shown on any lookup result.
Removed entries and retained codes that become headings
The 21 removed entries are listed below. Review the FY2027 index and tabular instructions to select a code supported by the record; a removed entry does not establish a one-to-one replacement.
These 15 retained codes become non-billable headings: D69.1, I42.0, I42.8, I49.8, M72.2, M86.8X1, M86.8X2, M86.8X3, M86.8X4, M86.8X5, M86.8X6, M86.8X7, M86.8X8, Z68.1, and Z87.890. Review their complete descendants in the FY2027 change list.
| Code | Description |
|---|---|
| S23.420 | Sprain of sternoclavicular (joint) (ligament) |
| S23.420A | Sprain of sternoclavicular (joint) (ligament), initial encounter |
| S23.420D | Sprain of sternoclavicular (joint) (ligament), subsequent encounter |
| S23.420S | Sprain of sternoclavicular (joint) (ligament), sequela |
| T52.8X | Toxic effects of other organic solvents |
| T52.8X1 | Toxic effect of other organic solvents, accidental (unintentional) |
| T52.8X1A | Toxic effect of other organic solvents, accidental (unintentional), initial encounter |
| T52.8X1D | Toxic effect of other organic solvents, accidental (unintentional), subsequent encounter |
| T52.8X1S | Toxic effect of other organic solvents, accidental (unintentional), sequela |
| T52.8X2 | Toxic effect of other organic solvents, intentional self-harm |
| T52.8X2A | Toxic effect of other organic solvents, intentional self-harm, initial encounter |
| T52.8X2D | Toxic effect of other organic solvents, intentional self-harm, subsequent encounter |
| T52.8X2S | Toxic effect of other organic solvents, intentional self-harm, sequela |
| T52.8X3 | Toxic effect of other organic solvents, assault |
| T52.8X3A | Toxic effect of other organic solvents, assault, initial encounter |
| T52.8X3D | Toxic effect of other organic solvents, assault, subsequent encounter |
| T52.8X3S | Toxic effect of other organic solvents, assault, sequela |
| T52.8X4 | Toxic effect of other organic solvents, undetermined |
| T52.8X4A | Toxic effect of other organic solvents, undetermined, initial encounter |
| T52.8X4D | Toxic effect of other organic solvents, undetermined, subsequent encounter |
| T52.8X4S | Toxic effect of other organic solvents, undetermined, sequela |
Complete list of added FY2027 ICD-10-CM entries
All 238 added entries are grouped by ICD-10-CM chapter. The tables include 190 billable codes and 48 non-billable headings. For a heading, select a complete billable code supported by the record. Source: the CMS FY2027 order file, effective October 1, 2026.
Chapter 2. Neoplasms (3 added entries)
| Code | Description | Billable |
|---|---|---|
| C78.31 | Secondary malignant neoplasm of larynx | Yes |
| C78.32 | Secondary malignant neoplasm of pharynx | Yes |
| C79.83 | Secondary malignant neoplasm of oral cavity | Yes |
Chapter 3. Blood & Immune Disorders (2 added entries)
| Code | Description | Billable |
|---|---|---|
| D69.11 | Glanzmann thrombasthenia | Yes |
| D69.19 | Other qualitative platelet defects | Yes |
Chapter 4. Endocrine, Nutritional & Metabolic (3 added entries)
| Code | Description | Billable |
|---|---|---|
| E89.83 | Postprocedural hypoglycemia following a procedure | No (header) |
| E89.830 | Post bariatric hypoglycemia | Yes |
| E89.838 | Other postprocedural hypoglycemia | Yes |
Chapter 5. Mental, Behavioral & Neurodevelopmental (1 added entry)
| Code | Description | Billable |
|---|---|---|
| F64.A | Gender identity disorder, in remission | Yes |
Chapter 9. Circulatory System (9 added entries)
| Code | Description | Billable |
|---|---|---|
| I42.00 | Dilated cardiomyopathy, unspecified | Yes |
| I42.01 | Familial-genetic dilated cardiomyopathy | Yes |
| I42.09 | Other dilated cardiomyopathy | Yes |
| I42.81 | Arrhythmogenic cardiomyopathy | Yes |
| I42.89 | Other cardiomyopathies not elsewhere classified | Yes |
| I47.22 | Catecholaminergic polymorphic ventricular tachycardia [CPVT] | Yes |
| I49.81 | Brugada syndrome | Yes |
| I49.82 | Ventricular bigeminy | Yes |
| I49.89 | Other specified cardiac arrhythmias not elsewhere classified | Yes |
Chapter 10. Respiratory System (7 added entries)
| Code | Description | Billable |
|---|---|---|
| J34.83 | Odontogenic sinusitis | No (header) |
| J34.830 | Odontogenic sinusitis, maxillary sinus | Yes |
| J34.831 | Odontogenic sinusitis, ethmoid sinus | Yes |
| J34.832 | Odontogenic sinusitis, frontal sinus | Yes |
| J34.833 | Odontogenic sinusitis, sphenoid sinus | Yes |
| J34.839 | Odontogenic sinusitis, unspecified | Yes |
| J4B | Pulmonary mycetoma | Yes |
Chapter 11. Digestive System (8 added entries)
| Code | Description | Billable |
|---|---|---|
| K31.B | Hypertrophic pyloric stenosis, in childhood | Yes |
| K6A | Diseases of the pelvis, not elsewhere classified | No (header) |
| K6A.0 | Pelvic abscess | No (header) |
| K6A.01 | Prevesical abscess | Yes |
| K6A.09 | Other pelvic abscess | Yes |
| K6A.8 | Other diseases of the pelvis, not elsewhere classified | Yes |
| K74.0A | Hepatic fibrosis, moderate fibrosis | Yes |
| K76.83 | Intestinal failure-associated liver disease | Yes |
Chapter 12. Skin & Subcutaneous Tissue (1 added entry)
| Code | Description | Billable |
|---|---|---|
| L02.237 | Carbuncle of flank | Yes |
Chapter 13. Musculoskeletal & Connective Tissue (33 added entries)
| Code | Description | Billable |
|---|---|---|
| M04.3 | VEXAS syndrome | Yes |
| M67.A | Plantar fasciitis | No (header) |
| M67.A0 | Plantar fasciitis, foot | No (header) |
| M67.A01 | Plantar fasciitis, right foot | Yes |
| M67.A02 | Plantar fasciitis, left foot | Yes |
| M67.A09 | Plantar fasciitis, unspecified foot | Yes |
| M72.20 | Plantar fascial fibromatosis, unspecified foot | Yes |
| M72.21 | Plantar fascial fibromatosis, right foot | Yes |
| M72.22 | Plantar fascial fibromatosis, left foot | Yes |
| M86.8X11 | Other osteomyelitis, right shoulder | Yes |
| M86.8X12 | Other osteomyelitis, left shoulder | Yes |
| M86.8X19 | Other osteomyelitis, unspecified shoulder | Yes |
| M86.8X21 | Other osteomyelitis, right upper arm | Yes |
| M86.8X22 | Other osteomyelitis, left upper arm | Yes |
| M86.8X29 | Other osteomyelitis, unspecified upper arm | Yes |
| M86.8X31 | Other osteomyelitis, right forearm | Yes |
| M86.8X32 | Other osteomyelitis, left forearm | Yes |
| M86.8X39 | Other osteomyelitis, unspecified forearm | Yes |
| M86.8X41 | Other osteomyelitis, right hand | Yes |
| M86.8X42 | Other osteomyelitis, left hand | Yes |
| M86.8X49 | Other osteomyelitis, unspecified hand | Yes |
| M86.8X51 | Other osteomyelitis, right thigh | Yes |
| M86.8X52 | Other osteomyelitis, left thigh | Yes |
| M86.8X59 | Other osteomyelitis, unspecified thigh | Yes |
| M86.8X61 | Other osteomyelitis, right lower leg | Yes |
| M86.8X62 | Other osteomyelitis, left lower leg | Yes |
| M86.8X69 | Other osteomyelitis, unspecified lower leg | Yes |
| M86.8X71 | Other osteomyelitis, right ankle and foot | Yes |
| M86.8X72 | Other osteomyelitis, left ankle and foot | Yes |
| M86.8X79 | Other osteomyelitis, unspecified ankle and foot | Yes |
| M86.8X80 | Other osteomyelitis, skull | Yes |
| M86.8X81 | Other osteomyelitis, face and sinuses | Yes |
| M86.8X89 | Other osteomyelitis, other site | Yes |
Chapter 14. Genitourinary System (3 added entries)
| Code | Description | Billable |
|---|---|---|
| N99.86 | Intraoperative and postprocedural complications and disorders of breast | No (header) |
| N99.860 | Intraoperative and postprocedural nipple ischemia | Yes |
| N99.861 | Intraoperative and postprocedural nipple necrosis | Yes |
Chapter 15. Pregnancy, Childbirth & the Puerperium (56 added entries)
Chapter 15 adds 56 entries, mostly ectopic pregnancy site specificity and vanishing twin syndrome detail. They are included for complete coverage of the release.
| Code | Description | Billable |
|---|---|---|
| O00.12 | Interstitial ectopic pregnancy without intrauterine pregnancy | No (header) |
| O00.121 | Right interstitial ectopic pregnancy without intrauterine pregnancy | Yes |
| O00.122 | Left interstitial ectopic pregnancy without intrauterine pregnancy | Yes |
| O00.129 | Unspecified interstitial ectopic pregnancy without intrauterine pregnancy | Yes |
| O00.13 | Interstitial ectopic pregnancy with intrauterine pregnancy | No (header) |
| O00.131 | Right interstitial ectopic pregnancy with intrauterine pregnancy | Yes |
| O00.132 | Left interstitial ectopic pregnancy with intrauterine pregnancy | Yes |
| O00.139 | Unspecified interstitial ectopic pregnancy with intrauterine pregnancy | Yes |
| O00.3 | Cesarean scar ectopic pregnancy | No (header) |
| O00.31 | Cesarean scar ectopic pregnancy without intrauterine pregnancy | Yes |
| O00.32 | Cesarean scar ectopic pregnancy with intrauterine pregnancy | Yes |
| O00.4 | Cervical ectopic pregnancy | No (header) |
| O00.41 | Cervical ectopic pregnancy without intrauterine pregnancy | Yes |
| O00.42 | Cervical ectopic pregnancy with intrauterine pregnancy | Yes |
| O00.5 | Cornual ectopic pregnancy | No (header) |
| O00.51 | Cornual ectopic pregnancy without intrauterine pregnancy | No (header) |
| O00.511 | Right cornual ectopic pregnancy without intrauterine pregnancy | Yes |
| O00.512 | Left cornual ectopic pregnancy without intrauterine pregnancy | Yes |
| O00.519 | Unspecified cornual ectopic pregnancy without intrauterine pregnancy | Yes |
| O00.52 | Cornual ectopic pregnancy with intrauterine pregnancy | No (header) |
| O00.521 | Right cornual ectopic pregnancy with intrauterine pregnancy | Yes |
| O00.522 | Left cornual ectopic pregnancy with intrauterine pregnancy | Yes |
| O00.529 | Unspecified cornual ectopic pregnancy with intrauterine pregnancy | Yes |
| O31.4 | Continuing pregnancy after vanishing twin syndrome of one fetus or more | No (header) |
| O31.40 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester | No (header) |
| O31.40X0 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester, not applicable or unspecified | Yes |
| O31.40X1 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester, fetus 1 | Yes |
| O31.40X2 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester, fetus 2 | Yes |
| O31.40X3 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester, fetus 3 | Yes |
| O31.40X4 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester, fetus 4 | Yes |
| O31.40X5 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester, fetus 5 | Yes |
| O31.40X9 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester, other fetus | Yes |
| O31.41 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester | No (header) |
| O31.41X0 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, not applicable or unspecified | Yes |
| O31.41X1 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, fetus 1 | Yes |
| O31.41X2 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, fetus 2 | Yes |
| O31.41X3 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, fetus 3 | Yes |
| O31.41X4 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, fetus 4 | Yes |
| O31.41X5 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, fetus 5 | Yes |
| O31.41X9 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, other fetus | Yes |
| O31.42 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester | No (header) |
| O31.42X0 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, not applicable or unspecified | Yes |
| O31.42X1 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, fetus 1 | Yes |
| O31.42X2 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, fetus 2 | Yes |
| O31.42X3 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, fetus 3 | Yes |
| O31.42X4 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, fetus 4 | Yes |
| O31.42X5 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, fetus 5 | Yes |
| O31.42X9 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, other fetus | Yes |
| O31.43 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, third trimester | No (header) |
| O31.43X0 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, third trimester, not applicable or unspecified | Yes |
| O31.43X1 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, third trimester, fetus 1 | Yes |
| O31.43X2 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, third trimester, fetus 2 | Yes |
| O31.43X3 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, third trimester, fetus 3 | Yes |
| O31.43X4 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, third trimester, fetus 4 | Yes |
| O31.43X5 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, third trimester, fetus 5 | Yes |
| O31.43X9 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, third trimester, other fetus | Yes |
Chapter 17. Congenital Malformations (9 added entries)
| Code | Description | Billable |
|---|---|---|
| Q87.A | Loeys-Dietz syndrome | Yes |
| QA1 | Genetic disorders associated with neoplasms, not elsewhere classified | No (header) |
| QA1.7 | Inherited neoplasm predisposition syndromes involving multiple systems, not elsewhere classified | No (header) |
| QA1.71 | Lynch syndrome | Yes |
| QA1.79 | Other inherited neoplasm predisposition syndrome of multiple systems | No (header) |
| QA1.790 | Familial cancer syndrome with pathogenic BRCA1 mutation | Yes |
| QA1.791 | Familial cancer syndrome with pathogenic BRCA2 mutation | Yes |
| QA1.792 | Li Fraumeni syndrome | Yes |
| QA1.798 | Other inherited neoplasm predisposition syndrome of multiple systems | Yes |
Chapter 18. Symptoms, Signs & Abnormal Findings (1 added entry)
| Code | Description | Billable |
|---|---|---|
| R78.72 | Abnormal gadolinium level in blood | Yes |
Chapter 19. Injury, Poisoning & External Causes (85 added entries)
Chapter 19 adds 85 entries, including organic-solvent expansions, hexamethylene diisocyanate entries, and medetomidine entries.
| Code | Description | Billable |
|---|---|---|
| T52.81 | Toxic effects of alkenes | No (header) |
| T52.811 | Toxic effect of alkenes, accidental (unintentional) | No (header) |
| T52.811A | Toxic effect of alkenes, accidental (unintentional), initial encounter | Yes |
| T52.811D | Toxic effect of alkenes, accidental (unintentional), subsequent encounter | Yes |
| T52.811S | Toxic effect of alkenes, accidental (unintentional), sequela | Yes |
| T52.812 | Toxic effect of alkenes, intentional self-harm | No (header) |
| T52.812A | Toxic effect of alkenes, intentional self-harm, initial encounter | Yes |
| T52.812D | Toxic effect of alkenes, intentional self-harm, subsequent encounter | Yes |
| T52.812S | Toxic effect of alkenes, intentional self-harm, sequela | Yes |
| T52.813 | Toxic effect of alkenes, assault | No (header) |
| T52.813A | Toxic effect of alkenes, assault, initial encounter | Yes |
| T52.813D | Toxic effect of alkenes, assault, subsequent encounter | Yes |
| T52.813S | Toxic effect of alkenes, assault, sequela | Yes |
| T52.814 | Toxic effect of alkenes, undetermined | No (header) |
| T52.814A | Toxic effect of alkenes, undetermined, initial encounter | Yes |
| T52.814D | Toxic effect of alkenes, undetermined, subsequent encounter | Yes |
| T52.814S | Toxic effect of alkenes, undetermined, sequela | Yes |
| T52.82 | Toxic effects of cycloparaffins | No (header) |
| T52.821 | Toxic effect of cycloparaffins, accidental (unintentional) | No (header) |
| T52.821A | Toxic effect of cycloparaffins, accidental (unintentional), initial encounter | Yes |
| T52.821D | Toxic effect of cycloparaffins, accidental (unintentional), subsequent encounter | Yes |
| T52.821S | Toxic effect of cycloparaffins, accidental (unintentional), sequela | Yes |
| T52.822 | Toxic effect of cycloparaffins, intentional self-harm | No (header) |
| T52.822A | Toxic effect of cycloparaffins, intentional self-harm, initial encounter | Yes |
| T52.822D | Toxic effect of cycloparaffins, intentional self-harm, subsequent encounter | Yes |
| T52.822S | Toxic effect of cycloparaffins, intentional self-harm, sequela | Yes |
| T52.823 | Toxic effect of cycloparaffins, assault | No (header) |
| T52.823A | Toxic effect of cycloparaffins, assault, initial encounter | Yes |
| T52.823D | Toxic effect of cycloparaffins, assault, subsequent encounter | Yes |
| T52.823S | Toxic effect of cycloparaffins, assault, sequela | Yes |
| T52.824 | Toxic effect of cycloparaffins, undetermined | No (header) |
| T52.824A | Toxic effect of cycloparaffins, undetermined, initial encounter | Yes |
| T52.824D | Toxic effect of cycloparaffins, undetermined, subsequent encounter | Yes |
| T52.824S | Toxic effect of cycloparaffins, undetermined, sequela | Yes |
| T52.89 | Toxic effects of other organic solvents | No (header) |
| T52.891 | Toxic effect of other organic solvents, accidental (unintentional) | No (header) |
| T52.891A | Toxic effect of other organic solvents, accidental (unintentional), initial encounter | Yes |
| T52.891D | Toxic effect of other organic solvents, accidental (unintentional), subsequent encounter | Yes |
| T52.891S | Toxic effect of other organic solvents, accidental (unintentional), sequela | Yes |
| T52.892 | Toxic effect of other organic solvents, intentional self-harm | No (header) |
| T52.892A | Toxic effect of other organic solvents, intentional self-harm, initial encounter | Yes |
| T52.892D | Toxic effect of other organic solvents, intentional self-harm, subsequent encounter | Yes |
| T52.892S | Toxic effect of other organic solvents, intentional self-harm, sequela | Yes |
| T52.893 | Toxic effect of other organic solvents, assault | No (header) |
| T52.893A | Toxic effect of other organic solvents, assault, initial encounter | Yes |
| T52.893D | Toxic effect of other organic solvents, assault, subsequent encounter | Yes |
| T52.893S | Toxic effect of other organic solvents, assault, sequela | Yes |
| T52.894 | Toxic effect of other organic solvents, undetermined | No (header) |
| T52.894A | Toxic effect of other organic solvents, undetermined, initial encounter | Yes |
| T52.894D | Toxic effect of other organic solvents, undetermined, subsequent encounter | Yes |
| T52.894S | Toxic effect of other organic solvents, undetermined, sequela | Yes |
| T59.82 | Toxic effects of hexamethylene diisocyanate | No (header) |
| T59.821 | Toxic effect of hexamethylene diisocyanate, accidental (unintentional) | No (header) |
| T59.821A | Toxic effect of hexamethylene diisocyanate, accidental (unintentional), initial encounter | Yes |
| T59.821D | Toxic effect of hexamethylene diisocyanate, accidental (unintentional), subsequent encounter | Yes |
| T59.821S | Toxic effect of hexamethylene diisocyanate, accidental (unintentional), sequela | Yes |
| T59.822 | Toxic effect of hexamethylene diisocyanate, intentional self-harm | No (header) |
| T59.822A | Toxic effect of hexamethylene diisocyanate, intentional self-harm, initial encounter | Yes |
| T59.822D | Toxic effect of hexamethylene diisocyanate, intentional self-harm, subsequent encounter | Yes |
| T59.822S | Toxic effect of hexamethylene diisocyanate, intentional self-harm, sequela | Yes |
| T59.823 | Toxic effect of hexamethylene diisocyanate, assault | No (header) |
| T59.823A | Toxic effect of hexamethylene diisocyanate, assault, initial encounter | Yes |
| T59.823D | Toxic effect of hexamethylene diisocyanate, assault, subsequent encounter | Yes |
| T59.823S | Toxic effect of hexamethylene diisocyanate, assault, sequela | Yes |
| T59.824 | Toxic effect of hexamethylene diisocyanate, undetermined | No (header) |
| T59.824A | Toxic effect of hexamethylene diisocyanate, undetermined, initial encounter | Yes |
| T59.824D | Toxic effect of hexamethylene diisocyanate, undetermined, subsequent encounter | Yes |
| T59.824S | Toxic effect of hexamethylene diisocyanate, undetermined, sequela | Yes |
| T65.85 | Toxic effect of medetomidine | No (header) |
| T65.851 | Toxic effect of medetomidine, accidental (unintentional) | No (header) |
| T65.851A | Toxic effect of medetomidine, accidental (unintentional), initial encounter | Yes |
| T65.851D | Toxic effect of medetomidine, accidental (unintentional), subsequent encounter | Yes |
| T65.851S | Toxic effect of medetomidine, accidental (unintentional), sequela | Yes |
| T65.852 | Toxic effect of medetomidine, intentional self-harm | No (header) |
| T65.852A | Toxic effect of medetomidine, intentional self-harm, initial encounter | Yes |
| T65.852D | Toxic effect of medetomidine, intentional self-harm, subsequent encounter | Yes |
| T65.852S | Toxic effect of medetomidine, intentional self-harm, sequela | Yes |
| T65.853 | Toxic effect of medetomidine, assault | No (header) |
| T65.853A | Toxic effect of medetomidine, assault, initial encounter | Yes |
| T65.853D | Toxic effect of medetomidine, assault, subsequent encounter | Yes |
| T65.853S | Toxic effect of medetomidine, assault, sequela | Yes |
| T65.854 | Toxic effect of medetomidine, undetermined | No (header) |
| T65.854A | Toxic effect of medetomidine, undetermined, initial encounter | Yes |
| T65.854D | Toxic effect of medetomidine, undetermined, subsequent encounter | Yes |
| T65.854S | Toxic effect of medetomidine, undetermined, sequela | Yes |
Chapter 21. Factors Influencing Health Status (Z codes) (17 added entries)
| Code | Description | Billable |
|---|---|---|
| Z68.18 | Body mass index [BMI] 18.4 or less, adult | Yes |
| Z68.19 | Body mass index [BMI] 18.5-19.9, adult | Yes |
| Z77.013 | Contact with and (suspected) exposure to gadolinium | Yes |
| Z77.32 | Contact with and (suspected) exposure to burn pits in war theater | Yes |
| Z77.33 | Contact with and (suspected) exposure to Agent Orange | Yes |
| Z77.4 | Contact with and (suspected) exposure to blast overpressure | No (header) |
| Z77.40 | Contact with and (suspected) exposure to unspecified blast overpressure | Yes |
| Z77.41 | Contact with and (suspected) exposure to low-level blast overpressure | Yes |
| Z77.42 | Contact with and (suspected) exposure to high-level blast overpressure | Yes |
| Z77.49 | Contact with and (suspected) exposure to other blast overpressure | Yes |
| Z86.17 | Personal history of Clostridioides difficile infection | Yes |
| Z87.8901 | Personal history of social gender transition | Yes |
| Z87.8902 | Personal history of medical gender transition | Yes |
| Z87.8903 | Personal history of surgical gender transition | Yes |
| Z87.8904 | Personal history of intersex surgery | Yes |
| Z87.8909 | Personal history of unspecified gender transition | Yes |
| Z87.893 | Personal history of gender detransition | Yes |
How should coders prepare for the FY2027 cutover?
- Review saved codes. Check favorites against the removed entries and the 15 retained codes that become headings. Prepare replacements for October 1, 2026; use the edition applicable to the encounter or discharge.
- Prepare templates and pick lists. Schedule the FY2027 choices for the October 1 cutover.
- Flag the new specificity. Queue documentation queries for cardiomyopathy type, arrhythmia type, low BMI, exposure history, and inherited syndromes so the detail is in the note.
- Check mapping coverage. The PY2027 Initial mapping does not cover these additions. Do not infer an HCC or RAF value for them.
- Re-run a sample. Test a batch of recent charts against the FY2027 set to see where your specificity has to change.
Check the code-set effective date and the mapping source period separately before using a result.
Frequently asked questions
When do the FY2027 ICD-10-CM codes take effect?
The FY2027 release takes effect October 1, 2026. Use the edition applicable to the encounter or discharge date, including any April updates.
What ICD-10-CM codes change starting October 1, 2026?
The FY2027 ICD-10-CM order file adds 238 entries: 190 billable codes and 48 non-billable headings. It removes 21 entries: 15 billable codes and 6 headings. Another 15 retained codes become non-billable headings, so 30 formerly billable codes need review. The release takes effect October 1, 2026. Chapter 9 adds cardiac specificity. Chapter 17 includes Lynch syndrome and BRCA-related inherited predisposition syndromes; VEXAS syndrome is in Chapter 13.
How many new ICD-10-CM codes are there for FY2027?
The FY2027 ICD-10-CM order file adds 238 entries: 190 billable codes and 48 non-billable headings. It removes 21 entries: 15 billable codes and 6 headings. Another 15 retained codes become non-billable headings, so 30 formerly billable codes need review. The release takes effect October 1, 2026. Counts compare the FY2027 and FY2026 April order files.
Do the new FY2027 codes affect HCC risk scores?
CMS has published the Payment Year 2027 Initial ICD-10-CM mappings. That file does not cover the FY2027 additions listed here. An ICD-10-CM fiscal year and an HCC payment year identify different releases. No HCC assignment or RAF value for these new codes is established by this article.
What happened to I42.0 dilated cardiomyopathy?
I42.0 becomes a non-billable heading on October 1, 2026. Select I42.00 (unspecified), I42.01 (familial-genetic), or I42.09 (other) when supported by the record and the applicable edition.
Is I49.8 still billable in FY2027?
No. I49.8 (other specified cardiac arrhythmias) becomes a non-billable category header on October 1, 2026. Code instead to I49.81 (Brugada syndrome), I49.82 (ventricular bigeminy), or I49.89 based on the documented arrhythmia.
What do the 21 removed FY2027 entries include?
The 21 removed entries include 15 billable codes and 6 headings. Review the FY2027 index and tabular instructions for an appropriate code; do not assume a one-to-one replacement.
Related Tools
ICD-10 to HCC Mapping Tool
Check a diagnosis against the mapping source period shown in the tool.
ICD-10 Encoder
Look up ICD-10-CM codes and check their source period and instructional notes.
RAF Calculator
CMS-HCC V28 Payment Year 2026 scoring with complete member context. No score is shown unless the required source and calculation checks pass.
FY2027 ICD-10-CM changes
Review added entries, removed entries, and codes that become headings, with CMS source files.
HCC Buddy Coding Team
Editorial
Every HCC Buddy article is checked against the current CMS-HCC model and the active FY ICD-10-CM tabular release before it publishes.
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