It’s been unusually warm in Colorado this year and the flowers and trees are a bit confused and starting to bud early. Springtime in the Rockies comes with heavy, wet snow. As I write this, we are getting snow. Hopefully, our budding trees and lilacs will survive the frost and bloom.
In order to survive and thrive in healthcare, we must be aware of the healthcare climate, understanding the timing of key changes. Throughout the year, we look for guideline and code releases. In recent years, the Cooperating Parties have released ICD-10-CM guideline and code changes twice a year with effective dates of October 1 and April 1. The easiest way to find these guideline and code updates is to go to the CDC website and click Search, type in ICD-10-CM, click on ICD-10-CM Files | Classification of Diseases, Functioning, and Disability.
For ICD-10-CM guidelines changes, simply click on ICD-10-CM FY25, April 1, 2026, then on ICD-10-CM April 1 2026 Guidelines Final.pdf. By scrolling through the guidelines, you can easily identify any bolded or italicized text. Bolded text represents any narrative changes and italicized text indicates revisions to headings. The only changes in the most recent guidelines are the addition of clarifying language in Chapter 9 at Guideline I.C.9.a 1 and the correction to category QA0 in Chapter 17.
To identify code updates, open icd10cm-addenda-April-1-2026.zip, open the Zip file, and double-click on icd10cm-tabular-addenda-April-1-2026. As you scroll through the various chapters, you will see the additions, deletions, and revisions for pertinent chapters. Start first with the areas of your specialty and notify your providers of the changes to the code set and the need for any additional specificity in their documentation.
Another notable change is the legislation regarding telehealth. Per the Telehealth policy website, “Recent legislation authorized an extension of many of the Medicare telehealth flexibilities through December 31, 2027.” On this site, you will find information regarding extensions of telehealth access options and telehealth specific to rural health and behavioral health. Medicare patients can still receive telehealth in their home for expanded services. See 2026 List of Telehealth Services which will download the Zip file. Medicare has also posted a Telehealth FAQ on their Telehealth coverage website. Please note that private payers may have other telehealth policies. It is important to check your contracted payers’ coverage and payment policies.
I hope that you are starting to enjoy the warmer weather where you live and work as our season changes from Winter to Spring! If you’re a gardener like me, you are looking forward to getting out and playing in the dirt. Small effort, great reward! Happy planting!
If you have found this information helpful, please share it with your colleagues. And if you know anyone who is interested in becoming a Certified Professional Coder (CPC), I would appreciate your referral to Medisense. Our next 20-week course begins on July 11, 2026. Learn more about the course on our classes page.
