ICD‑10‑CM April 2026 Update
Effective April 1 – September 30, 2026
ProTrust Billing Partners LLC
6/9/20261 min read
The April ICD‑10‑CM update is a small mid‑year release, but it still brings a few important changes that affect everyday coding. There are no new or deleted diagnosis codes this cycle. Instead, the update focuses on instructional note revisions that change how certain codes can be used together.
What Changed
1. Some Excludes1 notes were changed to Excludes2
This is the biggest update. Codes that previously couldn’t be reported together may now be allowed when the documentation supports it.
This helps:
Capture more complete clinical pictures
Reduce under‑coding
Improve HCC accuracy
Avoid denials tied to old Excludes1 rules
A few areas affected include:
Certain neoplasm codes
Drug poisoning/adverse effect categories
Long‑term opioid use
2. Updates to coding instructions
Several instructions were clarified or adjusted, including:
“Code first”
“Use additional code”
“Code also”
Alphabetic Index entries
These changes can shift sequencing, so it’s worth double‑checking familiar codes.
3. No new diagnosis codes
This update is all about how we use existing codes, not adding new ones.
Why It Matters
Even small note changes can influence:
How chronic conditions are reported
Which codes can be paired together
HCC capture
Audit readiness
Claim accuracy
Relying on memory can lead to missed opportunities or incorrect exclusions.
What Teams Should Do
Review the updated Excludes1 → Excludes2 notes
Update internal cheat sheets and EHR prompts
Re‑educate providers on new allowable code combinations
Double‑check sequencing for April encounters
Audit a small sample of early‑April charts to ensure correct application
The April update is simple but meaningful. There are no new codes, but the rules around using existing codes have changed, especially where Excludes1 notes were relaxed. These updates support more accurate, complete, and compliant coding for the rest of the fiscal year.