2027 CPT & ICD-10-CM updates
Two code sets, two effective dates, and one of the largest maternity coding restructurings in years. Here's what changes, what to update, and when each takes effect.
Note the sequence: despite the “2027” label, the ICD-10-CM update lands three months first, on October 1, 2026. CPT follows on January 1, 2027.
CPT 2027: key changes, new codes and coding guidance
The AMA has announced significant updates to the 2027 CPT® code set, designed to better reflect current clinical practice, improve reporting specificity and support more meaningful healthcare data.
The updates take effect January 1, 2027, requiring healthcare organizations, coders, billing teams, payers and technology vendors to review coding workflows and prepare systems ahead of implementation.
Maternity care, split into four distinct phases
Historically, maternity care has largely been represented through global maternity codes that combine substantial portions of pregnancy-related care into a single code. After nearly two years of collaboration with ACOG and other specialty organizations, the CPT Editorial Panel has approved a restructuring into granular, phase-specific reporting.
Care before labor begins
Management through labor
The delivery itself
Now reported via E/M
What's deleted, added and revised
The 2027 restructuring removes the existing global maternity reporting approach. Deleted codes are no longer valid for dates of service beginning January 1, 2027.
No longer valid from Jan 1, 2027
Support phase-specific reporting
Existing codes, updated descriptors
How postpartum care will be reported
Under the revised approach, existing postpartum care codes are deleted. Postpartum services will generally be reported using applicable Evaluation and Management (E/M) codes on an encounter basis.
- Routine postpartum care performed on the same calendar day as delivery is included in the delivery care code.
- For facility-based births, subsequent hospital care codes are reported for each applicable management day after the delivery date until discharge.
- A new procedure code for uterine tamponade has been added.
Global maternity codes can make it difficult to distinguish the actual services provided during a patient's pregnancy.
The new structure provides more visibility into individual services and better accommodates team-based obstetric care, variations in care delivery, telehealth and increasing clinical complexity. For healthcare organizations, the impact goes beyond learning new codes - coding policies, billing workflows, claims edits, EHR configurations and revenue cycle processes may all require updates before January 2027.
Other CPT 2027 changes
Editorial Panel actions released during 2025 and 2026 show additional changes for January 2027, involving surgical procedures, diagnostic services, prostate biopsy reporting, artificial intelligence-related services and other emerging technologies.
Prostate biopsy services
The Panel approved revisions affecting prostate biopsy reporting, including changes to existing codes to better identify:
- Imaging guidance
- Fusion-targeted procedures, where applicable
- Procedures performed with or without regional anesthesia
Also includes revisions to add-on code reporting and deletion of certain existing codes.
Artificial intelligence in CPT
May 2026 Editorial Panel actions include new Category III codes for augmentative algorithmic analysis of histomorphologic features in cancer tissue:
The Panel also accepted additional Category III codes for stereotactic intracerebral implantation of therapeutic agents. The AMA continues refining its AI taxonomy around assistive, augmentative and autonomous applications.
What organizations should review
Annual code updates are increasingly about more than adding and deleting procedure codes. The AMA specifically recommends preparation by physicians, coders, auditors, payers, EHR vendors and other stakeholders ahead of January 1, 2027.
FY 2027 ICD-10-CM: key changes, new codes and coding guidance
CMS has released the FY 2027 updates to the ICD-10-CM classification system. Compared with the previous year, this update introduces considerably fewer new codes - in total, 190 new codes, 30 deleted codes, and 4 revised code titles. These changes become applicable beginning October 1, 2026.
One new guideline, four clarified
Changes to the Official ICD-10-CM Guidelines for Coding and Reporting are relatively limited this year - one new guideline, plus wording changes or added clarification to four existing ones.
Hypertension and heart disease
In I.C.9.a.1, the addition of “one or more” clarifies that a code from category I11, Hypertensive heart disease, should be assigned when the patient has one or more of the qualifying heart conditions listed. For hypertensive crisis, I.C.9.a.10 has been expanded - the “Code also” instruction now includes I1A, Resistant hypertension.
Genetic disorders in Chapter 17
The title of Chapter 17 has been expanded to include “genetic disorders.” Related guideline language has been updated so genetic disorders are referenced alongside congenital malformations, deformations and chromosomal abnormalities.
Diethylstilbestrol (DES) exposure
Z84.A, Family history of exposure to diethylstilbestrol, has been incorporated into family-history Z-code guidance with a note describing when to report it. Guidance for Z91.B, Personal risk factor of exposure to diethylstilbestrol, clarifies that the code applies when the patient experienced direct exposure in utero.
Entries that now point somewhere else
Much of the Index change relates to new codes and inclusion terms. But FY 2027 also includes instances where existing entries now direct coders to different codes - or different chapters entirely.
- Polyp, cecum
Previously directed to a benign neoplasm code in Chapter 2. Now directs to a colon polyp code in Chapter 11, Diseases of the Digestive System.
- De Morgan's spots
Reassigned within the Alphabetic Index.
- R41.0
Additional terminology establishes it as the default code for a diagnosis of acute confusion.
- Sinusitis of odontogenic origin
New subterms enable coders to identify and report it.
The largest share of the changes
Many updates introduce new codes or expand existing structures for greater diagnostic specificity. But changes aren't limited to code additions - the Tabular List also carries important modifications to coding instructions:
- Excludes1 and Excludes2 notes
- Code First instructions
- Code Also instructions
- Use Additional Code instructions
- Changes in the classification of certain Excludes notes
Review the relevant Tabular List instructions carefully before assigning codes under the FY 2027 classification.
Notable changes, by chapter
A closer look at some of the most significant additions in the FY 2027 update.
Neoplasms
Three new codes provide more specific reporting for secondary malignant neoplasms involving respiratory sites.
Endocrine, Nutritional and Metabolic Diseases
Two new codes for postprocedural hypoglycemia, including hypoglycemia occurring after bariatric procedures.
Both carry a “Use Additional” instruction directing coders to report the hypoglycemia level using E16.A-. Classified as CCs for 2027.
Diseases of the Circulatory System
The classification of dilated cardiomyopathy is expanded for greater specificity around genetic causes, and I42.8 is expanded alongside it.
All five codes are classified as CCs for 2027.
Diseases of the Respiratory System
New codes for sinusitis originating from a dental source, separated by affected sinus.
J4B carries a “Code also” instruction for associated infections such as aspergillosis, with reciprocal instructions under the relevant aspergillosis codes. These new codes are classified as CCs for 2027.
Pregnancy, Childbirth and the Puerperium
Category O00, Ectopic pregnancy, gains new subcategories for ectopic pregnancies involving cesarean scar, cervix, and cornua. The fifth character identifies whether an intrauterine pregnancy is present; where applicable, a sixth character provides laterality.
Factors Influencing Health Status and Contact with Health Services
Z68.1 is expanded with more specific fifth-character codes, and additional Z codes capture specific exposures and personal histories.
The newly created Z68.18 and Z68.19 codes are classified as CCs.
Several Z codes are removed from the CC list
The FY 2027 update removes these codes related to homelessness and housing instability. Organizations relying on them for severity capture should review the downstream impact on DRG assignment before October 1, 2026.
Two code sets change in the next twelve months. Both affect your claims.
Early preparation reduces coding errors, prevents claim rejections, and makes sure billing systems are ready when each code set takes effect. Our coders and auditors can review your workflows before then.
Talk to our coding team