2026 ICD-10-CM Updates for Chiropractic Practices

Effective Date: Oct. 1, 2025.

Each year, ICD-10-CM is updated on Oct. 1. For 2026, there are 74,179 total codes, with 487 additions, 28 deletions and 38 revisions.

Key rule: Code changes are based on date of service, not the claim submission date. Services performed on/after Oct. 1 must use the new codes.

Areas Impacting Chiropractic Documentation

While no changes affect the common spinal or extraspinal codes most frequently used by DCs, several updates may still affect your claims – particularly for comorbidities, referred pain, or trauma cases.

Pain & Tenderness (R-Codes)

Deleted: R10.2 Pelvic and perineal pain

Added:

• R10.20 – R10.23 Pelvic/perineal pain (unspecified, right, left, bilateral)
• R10.24 Suprapubic pain
• R10.85 Abdominal pain, multiple sites
• R10.8A1 – R10.8A3 Flank/suprapubic tenderness (side-specific)
• R10.8A9 Flank tenderness, unspecified
• R10.A0 – R10.A3 Flank pain (side-specific and unspecified)

Contusions (S-Codes)

Deleted: S30.1XXA/D/S Contusion of abdominal wall.

Added:

• S30.11XA – S30.11XS Abdominal wall contusion (initial, subsequent, sequela)
• S30.12XA – S30.12XS Groin contusion
• S30.13XA – S30.13XS Flank (latus) region contusion

Musculoskeletal & Other Relevant Codes

• M21.159 Varus deformity, unspecified hip
• M61.129 Myositis ossificans progressive, unspecified upper arm
• R39.851 – R39.859 Costovertebral (angle) tenderness (side-specific)

Neurology (Multiple Sclerosis – G35)

Deleted: G35 Multiple sclerosis.

Added:

• G35.A Relapsing-remitting MS
• G35.B0 – B2 Primary progressive MS (unspecified, active, non-active)
• G35.C0 – C2 Secondary progressive MS (unspecified, active, non-active)
• G35.D Multiple sclerosis, unspecified

Practical Impact for DCs

• 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• Claims risk: Using a deleted or outdated code after Oct. 1 will result in claim denial.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.