Minimal ICD-10-CM Updates Relevant to Chiropractic
Evan Gwilliam DC, MBA, QCC, CPC, CCPC, CPMA, CPCO, AAPC Fellow Senior Vice President, Practisync, WSCA Corporate Member
The official ICD-10 updates for Fiscal Year 2026 go into effect October 1st, 2025. The update contains 487 new, 28 deleted, and 38 revised ICD-10-CM diagnosis codes. These 2026 ICD-10-CM codes will be used for patient encounters from Oct. 1, 2025, through Sept. 30, 2026. The changes that are relevant to chiropractic are few, but there are a few that might apply that are symptom codes and codes that describe a patient’s socioeconomic status.
Symptom Codes
Chapter 18 in ICD-10 is for “Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)”. The instructions for this chapter tell us that “symptoms and signs, as opposed to diagnoses, are acceptable for reporting purposes when a related definitive diagnosis has not been established (confirmed) by the provider.” (ICD-10-CM Official Guidelines for Coding and Reporting FY 2026, section 1.B.4). Most, but not all, of the codes for symptoms are found in this chapter. If the reported codes only repeat the symptoms that the patient sought treatment for, that would indicate that the provider is unable to identify the cause. This provides a weaker justification for most kinds of treatment.
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R10.2 for pelvic and perineal pain was expanded to include five more options that report more location detail. The additions look like this (new codes in bold)
R10.2- Pelvic and perineal pain R10.20 Pelvic and perineal pain unspecified side R10.21 Pelvic and perineal pain right side R10.22 Pelvic and perineal pain left side R10.23 Pelvic and perineal pain bilateral R10.24 Suprapubic pain
Keep in mind that, as of Oct. 1, 2025, R10.2 is no longer a complete code. A fifth character is required. Claims with the old code, for dates of service prior to 10/1, will be denied. Be sure to update your billing software to reflect this change.
R10.8- for other abdominal pain was also expanded. (changes in bold) R10.8- Other abdominal pain R10.85 Abdominal pain of multiple sites Excludes1: abdominal rigidity NOS (R19.3)
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