Effective Date: Oct. 1, 2025
Each year, ICD-10-CM is updated on Oct. 1. For 2026, there are 74,179 total codes, 487 additions, 28 deletions, and 38 revisions.
Key rule: Code changes are based on date of service, not the claim submission date. Services before Oct. 1 use old codes; services on/after Oct. 1 must use the new codes.
Areas Impacting Acupuncture Documentation
While no changes affect the common pain codes most frequently used by acupuncturists, several updates may still affect your claims – particularly for abdominal pain and trauma, as well as the comorbidity of multiple sclerosis.
Pain & Tenderness (R-Codes)
Deleted: R10.2 Pelvic and perineal pain
Added:
Contusions (S-Codes)
Deleted: S30.1XXA/D/S Contusion of abdominal wall
Added:
Neurology (Multiple Sclerosis – G35)
Deleted: G35 Multiple sclerosis
Added:
Practical Impact for Acupuncturists
Coding precision is increasing: Many previously single codes (e.g., pelvic pain, contusion of abdominal wall, multiple sclerosis) now have laterality, site-specificity, and disease activity requirements.
Claims risk: Using a deleted or outdated code after Oct. 1 will result in claim denial.
Best practice: Update your EHR, superbills, and macros now to ensure correct code selection.
Fertility acupuncture sometimes gets presented as a narrow protocol: a handful of reproductive points applied uniformly across patients. What this case reinforced for me: The most powerful work happens when we read the whole picture. The hormone data, the constitutional tendency, the sleep, the digestion, and the menstrual pattern, so we can treat the environment the ovaries live inside.
Mast cell activation syndrome (MCAS) affects more than 15% of the U.S. population but evades most practitioners’ radar. Just five years ago, it wasn’t even on my radar, despite already having 20 years of experience as a clinician at that time. The more I dug (similar to leaky gut and post-COVID syndrome), the more I found my patients were suffering from this disorder.
The motivation behind our practice of medicine is important, impacting not just our experience but also the experiences of those we treat. It is perhaps for this reason that the aspiration to help not just some, but all beings heal, has historically been an important part of the medical tradition. To explain this, we need to consider how medicine is interwoven with other social domains.