From CalChiro’s Insurance Help Desk facilitator, Lisa Maciejewski-West, CMC CMOM CMIS CPCO CPMA, Owner/Founder of Gold Star Medical Business Services
It’s that time of year!
October 1 of each year is the day that updates to the ICD-10 Code Book take effect.
Why did the 2026 ICD-10 Code Changes take effect on October 1, 2025, and not on January 1, 2026?
Simply put, October 1 is the beginning of the government’s fiscal year. And the ICD 10 Code Book is managed in the USA by the CDC’s National Center on Health Statistics, a federal government entity. Each year, all 70,000+ ICD-10 codes are reviewed and either kept “as is”, expanded to allow for better specificity, or deleted altogether.
How does this affect billing? If you use a code that is no longer billable…it’s either been deleted or a more specific code has been created under that particular code tree, your claim will likely be denied.
For chiropractors, it’s important to pay particular attention to the changes/updates in Chapter 13 of the ICD-10 Code book, “Diseases of the Musculoskeletal System and Connective Tissue” (Codes M00–M99). This isn’t the only Chapter that may contain updates pertinent to Chiropractors. For example, “sprain/strain” codes (injury codes starting with the letter “S”) are found in Chapter 19 “Injury, Poisoning and Certain Other Consequences of External Causes” (Codes S00–T88).
The table below contains a summary of some of the key ICD-10 changes that could affect chiropractors. This is by no means a comprehensive list. Always refer to the newest ICD-10 Code book to confirm that the codes you wish to use are still in use! If you receive a rejection from your clearinghouse or payer on an ICD-10 code that you have been using, check for updates to that code. Most of the time, the code has been expanded to add more specificity to it. While the code you are using has not necessarily been deleted from the code book, the higher level of specificity would make the old code unbillable.
For Chiropractors, a complete copy of a 73,000+ code book may be a little bit of overkill. If you want a great resource ICD-10 Code Book specifically for DCs, check out Dr. Mario Fucinari’s book 2026 ICD-10 Coding of the Top 100 Conditions for the Chiropractic Office available here.
For more information about how Gold Star Medical can help you with your Insurance Billing, Credentialing and Compliance needs, reach out to Lisa through your HelpDesk link or email Lisa directly at info@goldstarmedical.net.
