ICD-10-CM Changes Related to Podiatry

The latest ICD-10-CM code set for 2026 takes effect October 1, 2025: All members should be using the new code set for services performed on or after this date. The new code set includes 487 new code additions, 28 deletions, and 38 modifications. Some of these are pertinent to foot and ankle care, including changes involving lower extremity ulcers, diabetes, and more. Members can learn more about these through the APMA website, including a webinar recorded by Jeffrey D. Lehrman, DPM, CPC.

Below are some ICD-10-CM changes podiatrists should review.

Type 2 Diabetes

The 2021 International Consensus Report coauthored by the ADA, EASD, Diabetes UK, the Endocrine Society, and others defines type 2 diabetes in remission as, "a return of HbA₁c to <6.5% (48 mmol/mol) that persists for at least 3 months after stopping glucose lowering pharmacotherapy."

If a type 2 diabetes in remission diagnosis played a role in the management provided during an encounter, that diagnosis should be reflected in the ICD-10-CM coding that accompanies the encounter.

Effective October 1, 2025, a new, complete ICD-10-CM code will be: E11.A Type 2 diabetes mellitus without complications in remission.

Shin Ulcers

Non-pressure chronic ulcers of the lower limb are represented by ICD-10-CM codes that begin with the code stem, L97- (Non-pressure chronic ulcer of lower limb, not elsewhere classified). Until October 1, 2025, the only 4th character options for this code stem are:

• L97.1- Non-pressure chronic ulcer of thigh
• L97.2- Non-pressure chronic ulcer of calf
• L97.3- Non-pressure chronic ulcer of ankle
• L97.4- Non-pressure chronic ulcer of heel and midfoot
• L97.5- Non-pressure chronic ulcer of other part of foot
• L97.8- Non-pressure chronic ulcer of other part of lower leg
• L97.9- Non-pressure chronic ulcer of unspecified part of lower leg

Before October 1, 2025, there was no coding option to represent a non-pressure chronic ulcer of the shin. This changes on October 1, 2025, with the introduction of a new inclusion term for L97.2- Non-pressure chronic ulcer of shin. With this change, non-pressure chronic ulcers of the shin will now be represented by the L97.2- codes.

Aggressive Fibromatosis

Aggressive fibromatosis, commonly referred to as "desmoid tumor" is an abnormal growth that can develop from muscle connective tissue and aponeuroses: It is nonmetastasizing, may demonstrate local infiltration into tissue, and typically displays a high risk of recurrence following surgical removal. This differs from typical plantar fibromatosis (Ledderhose Disease) in that plantar fibromatosis is typically confined to the fascia, does not involve muscle, and is not infiltrative in nature. Prior to the new code set, there was a diagnosis code representing desmoid tumor (D48.11), and effective October 1, 2025 "aggressive fibromatosis" will be added as an inclusion term under D48.11.

Multiple Sclerosis

Prior to October 1, 2025, G35 (Multiple sclerosis) was a complete code. Starting October 1, 2025, G35- will no longer be a complete code and will require additional characters. This change creates the following new codes:

• G35.A Relapsing-remitting multiple sclerosis
• G35.B- Primary progressive multiple sclerosis
  • G35.B0 Primary progressive multiple sclerosis, unspecified
  • G35.B1 Active primary progressive multiple sclerosis
  • G35.B2 Non-active primary progressive multiple sclerosis
• G35.C- Secondary progressive multiple sclerosis
  • G35.C0 Secondary progressive multiple sclerosis, unspecified
  • G35.C1 Active secondary progressive multiple sclerosis
  • G35.C2 Non-active secondary progressive multiple sclerosis
• G35.D Multiple sclerosis, unspecified

Financial Insecurity

Social determinants of health often play a role in patient care. Social determinants of health can also play a role in evaluation and management level selection. In many cases, it is appropriate to represent certain social determinants of health, such as financial insecurity, in the diagnosis coding that accompanies an encounter. Prior to October 1, 2025, Z59.86 (Financial insecurity) was a complete code. Starting October 1, 2025, Z59.86- will no longer be a complete code and will require additional characters. This change creates the following new codes:

• Z59.861 Financial insecurity, difficulty paying for utilities
• Z59.868 Other specified financial insecurity
• Z59.869 Financial insecurity, unspecified

Other changes going to effect on October 1, 2025, can be viewed online here.