As the leaves on the trees are beginning to change all around us, I am reminded again that the only constant in healthcare is change. To be successful in medical coding, we must embrace and adapt quickly to change.
Speaking of change, an exciting event happened last month – I retired from my full-time position as director of national coding education with Optum to devote more time to the things I love most – spending more time with our family (10 grandchildren), traveling, volunteer work, more time in the garden, and teaching coding for certification. I will continue to teach via my live virtual classroom two semesters a year, January to May and July to November, and may even expand the credential offerings each semester.
This time of year brings changes to the diagnostic coding guidelines and the code set. Reviewing the changes that become effective on October 1, 2025, helps us prepare for those updates and educate our providers, coders, and billers. The easiest way to do that is to go to the CDC website and pull down the ICD-10-CM Official Guidelines for Coding and Reporting and the Tabular Addenda.
In the Guidelines, be sure and look for any bold type. Pay particular attention to changes in diabetes and hypertension guidelines. There is a new guideline for diabetes in remission, and the hypertension guidelines clarify heart conditions that are assumed causal, when to use additional codes, and changes the language from “kidney involvement” to “chronic kidney disease.”
In the Tabular Addenda, look for additions, deletions and revisions to the code set by chapter. This makes it easy to focus on the codes that you use most in your specialty to quickly identify changes to the portion of the code set that will most impact your business. Also look for changes to the instructions of the code set; many times you will see that Excludes1 notes have now become Excludes2 notes. Remember, Excludes1 (one word – never) and Excludes2 (two words – sometimes maybe). This increases the number of times that we will now report codes together. Review Convention I.A.12. for more information.
I have also updated my Helpful Websites document on our Resources page and encourage you to take a look. There you will find updated links to all things pertaining to medical coding and the business of healthcare, my gift to you for taking the time to read this blog.
Enjoy learning about all the changes. Remember, the only constant is change. And if you know someone who is ready to make a change in their career by becoming a certified professional medical coder, I would appreciate your referral.
