As of Oct. 1 of this year, the 2025 ICD-10 updates became effective for all insurance companies.
While updates to the ICD-10 code set happen annually, the changes for 2025 include numerous revisions that directly impact chiropractic practices.
Of the couple hundred changes introduced, let’s take a closer look at the specific updates that matter most to doctors of chiropractic and how you can incorporate them seamlessly into your daily operations.
2025 ICD-10 Updates for DCs
The revisions and additions for 2025 offer more precise descriptions than previously, including the site and laterality of common conditions. For example, the new M51.360-M51.369 series for lumbar disc degeneration now allows you to code specifically based on whether the pain is confined to the lumbar region or the lower extremities.
Please note that the above is a selection of updates of interest to DCs and does not represent the full list of 2025 ICD-10 updates.
Your next steps
Update your electronic health record (EHR) settings to include the 2025 ICD-10 updates and mark the old codes inactive. Do not edit or delete the old codes, as they will still be used in old claims (we will discuss that next). Instead, make new entries for the new codes so they can be used as the active set. If you are importing the diagnosis list as an EHR feature, remember that we did not provide the full update list above. Unspecified codes are likely to result in rejections, denials or requests for additional documentation and should be avoided where possible.
Old claims
For any dates of service before Oct. 1, 2024, you must continue using the 2024 ICD-10 codes when submitting claims, even if the claim is submitted or resubmitted after the Oct. 1 deadline. Insurance companies will process these claims based on the date of service, not the date of submission. Therefore, it’s critical that your billing system is set up to retain access to both the old and new code sets until you collect old accounts receivable. Using the 2025 ICD-10 codes for services rendered prior to the cutoff date will result in claim rejections, delaying reimbursements and creating extra administrative work for your staff.
Check out this free resource for 2025 ICD-10 updates
American Chiropractic Billing is offering a free resource to help all providers with the transition. If you have any questions or need guidance about the new codes, send an email to Help@ACBilling.com. Lots of questions come in, so please be patient with the response time.
KONSTANTIN CHERNUKHIN is the founder of American Chiropractic Billing, providing affordable billing solutions specifically tailored for doctors of chiropractic nationwide. After operating a personal injury practice in the state of Washington for years, he has been dedicated to removing insurance headaches for all providers. Contact him at 360-298-9755 or Konstantin@ACBilling.com.