Written by Jessica Miller · Published November 12, 2026 · Last reviewed November 12, 2026
Not as a group. CDC's September 2026 topic packet lists 39 diagnosis topics but does not put an April date on any of them. The only sections labeled April 1, 2027 are proposed addenda edits. Comments on proposals being considered for October 1, 2027 close November 13, 2026.
| Proposal (proposed, not final) | What the packet proposes | Documentation it would ask for |
|---|---|---|
| Sepsis | Split organism sepsis codes into sepsis with organ dysfunction and generalized infection without it, for example A41.91 and A41.92. Retitle R65.2 to organ dysfunction associated with sepsis and R65.21 to septic shock. | Whether organ dysfunction is present and caused by the infection, and the organism when known |
| Heart failure with improved ejection fraction (HFimpEF) | New subcategories I50.A and I50.B | Prior reduced EF, later improvement, and acuity |
| Heart failure stages A and B | New codes Z91.86 (at risk for heart failure) and I51.82 (pre-heart failure) | The ACC/AHA stage, written in the note |
| Cardiogenic shock staging | R57.00 to R57.04 for SCAI stages, plus R5A.0 for SCAI Stage A (at risk) | The SCAI stage, named by the clinician |
| Diabetic foot ulcer | Recurrent ulcer and "in remission" codes under L97, plus exposed-structure terms | New or recurrent, healed or open, site, side, and deepest exposed structure |
Source: CDC September 15-16, 2026 topic packet . Every string above is a proposal. None is a valid code today.
What did the September 2026 ICD-10-CM meeting actually propose?
The ICD-10 Coordination and Maintenance (C&M) Committee is the public forum where CDC's National Center for Health Statistics (NCHS) presents proposed changes to ICD-10-CM. On September 15-16, 2026, it discussed 39 diagnosis topics. That is 39 topics, not 39 codes, and nothing was decided at the meeting.
Most topics propose several codes. One, "Organizing Principles for Classification of Ultra-rare and Genetic Conditions," is a discussion of how to classify those conditions, not a code request. So at most 38 topics ask for new or revised codes. The packet also carries separate proposed addenda: tabular and index cleanups, the external cause index, the Table of Drugs and Chemicals, and the Table of Neoplasms.
CDC's committee overview says: "No final decisions are made at committee meetings." Final decisions come through an HHS process after the comment period.
This week's hook is the ACDIS CDI Strategies item of November 12, 2026 , which says the 39 topics "are being considered for implementation on April 1, 2027" and then lists eight as April requests: acute posterior vitreous detachment, carotid web, chemotherapy-induced alopecia, HFimpEF, laryngopharyngeal reflux disease, neonatal supraventricular tachycardia, segmental vitiligo, and spasticity. ACDIS is a secondary source. CDC's own date labels are the authority, and they do not say that.
ICD-10-PCS procedure topics are a separate CMS written-comment process and are outside this article.
Are any of the proposals coming April 1, 2027?
Possibly some, but none is confirmed, and the packet does not date any topic for April. CDC set two comment deadlines for the September meeting: October 16, 2026, for items being considered for April 1, 2027, and November 13, 2026, for new codes and revisions being considered for October 1, 2027.
What the primary documents show:
- The packet labels addenda, not topics. A full-text search of the 197-page packet finds "April 1, 2027" in the timeline and on three addenda pages headed "All approved modifications will be effective April 1, 2027." Those April pages move existing categories, swap note types, and add index and table entries. They contain no lines marked "New code."
- Two topic pages point to October. The extreme immaturity of newborn and tenosynovial giant cell tumor proposals each include a proposed note that begins "Effective October 1, 2027."
- None of ACDIS's eight carries a date. The topic pages for HFimpEF, spasticity, and the other six have no April label, and the posted September presentations do not mention April 1, 2027.
- AHIMA read it the same way. Its October 8, 2026 letter commented only on the proposed addenda and said comments on the code proposals "being considered for October 1, 2027 implementation will be submitted at a later date."
The CDC timeline says any new codes for April 1 "will be announced" in November 2026 on the CDC ICD-10-CM files page and the CMS ICD-10 page . As of November 12, 2026, neither page lists an April 1, 2027 diagnosis release. Both still show the October 1, 2026 (FY2027) files for services through September 30, 2027.
Our April 2027 NCD coding revisions article covers a different April change: Medicare coverage edits, not new ICD-10-CM codes.
Which proposals would change CDI documentation the most?
Sepsis, the two heart failure proposals, cardiogenic shock staging, and diabetic foot ulcers would ask the most of hospital documentation. This ranking is by documentation burden only. No topic page in the packet mentions MS-DRG, CC/MCC, or payment effects, so do not budget on them yet.
Sepsis. CDC calls it "a detailed proposal for changes to ICD-10-CM regarding the definition of sepsis based on" Sepsis-3. Today, R65.20 is "Severe sepsis without septic shock" and R65.21 is "Severe sepsis with septic shock." The proposal would retitle R65.2 as organ dysfunction associated with sepsis, retitle R65.21 as septic shock, and split many organism codes in two. "Impending sepsis" would sit under the codes without organ dysfunction. If adopted, a note that says "sepsis" without tying organ dysfunction to the infection would leave the coder short.
Heart failure with improved ejection fraction. The packet notes that current guidance directs coding HFimpEF as chronic diastolic heart failure (I50.32), which the requestor, Baylor Scott & White Health, says misrepresents the underlying physiology. The proposed I50.A and I50.B subcategories would need the EF history in the record, not just today's number.
Heart failure stages A and B. These would add codes for "At risk for heart failure" and "Pre-heart failure." Providers would need to write the stage.
Cardiogenic shock. Today R57.0 covers every level of cardiogenic shock. The proposal adds codes by SCAI stage, so the stage must appear in the clinician's note.
Diabetic foot ulcers. The Wound Care Collaborative Community asks for recurrent and in-remission ulcer codes and for terms by exposed structure.
For the codes that did take effect on October 1, 2026, see our FY2027 ICD-10-CM new codes explainer .
When does a proposed code become final, and what should teams do now?
A proposed code is final only when CDC or CMS publishes it in official files with an effective date. For any April 2027 changes, that starts with the November 2026 announcement and files by February 1, 2027. For the October 1, 2027 (FY2028) set, final addenda are due in June 2027.
| Date | What the CDC timeline says | Track |
|---|---|---|
| October 16, 2026 | Comment deadline (closed) | April 1, 2027 |
| November 2026 | Any new codes for April 1 announced | April 1, 2027 |
| November 13, 2026 | Comment deadline | October 1, 2027 |
| February 1, 2027 | All update files, including April 1, posted | April 1, 2027 |
| April 1, 2027 | Any new or revised codes implemented | April 1, 2027 |
| April 2027 | FY 2028 IPPS proposed rule references codes finalized to date and proposed MS-DRG revisions | October 1, 2027 |
| June 2027 | Final addenda posted | October 1, 2027 |
| August 1, 2027 | IPPS final rule expected, with links to all final codes | October 1, 2027 |
| October 1, 2027 | New and revised codes take effect | October 1, 2027 |
A short checklist for HIM, coding, and CDI leaders:
- Comment by November 13 if you plan to. Send diagnosis comments to nchsicd10CM@cdc.gov, the address in the packet. CDC gives no time of day or time zone, so send early.
- Keep coding from the FY2027 files. They cover services from October 1, 2026 through September 30, 2027, unless an official April 1 update replaces them.
- Do not load proposed numbers into templates, problem lists, favorites, or query forms.
- Watch two pages in November: the CDC files page and the CMS ICD-10 page.
- Educate on documentation that counts today. Heart failure type and acuity, the link between infection and organ dysfunction, and ulcer site and depth already drive FY2027 code choice.
- Audit before and after any change. Our guide to periodic coding audits and CDI metrics covers the baseline.
Where MediCodio AI fits is narrower than the code set. Complete charts flow through AutoPilot for fully autonomous coding. Charts where the documentation is thin or contradictory stay in CoPilot, where certified coders review and finalize the output. MediCodio AI keeps a 100% code-level audit trail. Every code ships with its documentation passage and the compliance rule behind it, so a team can show what supported each code under the code set in effect on the date of service.
Frequently asked questions
Are 39 new ICD-10-CM codes coming on April 1, 2027?
No. The September 2026 meeting discussed 39 diagnosis topics, not 39 codes, and one topic was a classification-principles discussion. CDC's packet does not put an April date on any topic. Only certain addenda pages are labeled April 1, 2027. CDC says any new April codes will be announced in November 2026.
Which proposals did ACDIS list for April, and does CDC agree?
ACDIS listed eight: acute posterior vitreous detachment, carotid web, chemotherapy-induced alopecia, HFimpEF, laryngopharyngeal reflux, neonatal supraventricular tachycardia, segmental vitiligo, and spasticity. CDC's packet and presentations do not date those topics for April. Treat the ACDIS list as unconfirmed until CDC's November announcement or official April files say otherwise.
Can coders use the proposed sepsis or heart failure codes now?
No. Proposed strings such as A41.91, I50.A, or R57.01 are not valid codes. Keep using the FY2027 ICD-10-CM files for services from October 1, 2026 through September 30, 2027, plus any official April 1, 2027 addenda for dates of service on or after April 1 once they post.
When is the comment deadline for the October 1, 2027 proposals?
CDC's deadline for comments on new codes and revisions being considered for October 1, 2027 is November 13, 2026. The April 1, 2027 track closed October 16, 2026. Diagnosis comments go to the CDC address in the packet. CDC does not state a time zone, so do not wait until late in the day.
Will these proposals change MS-DRG assignment or payment?
The packet does not say. No topic page mentions MS-DRG, CC/MCC, or payment effects. For codes that reach the October 1, 2027 set, CMS proposes MS-DRG revisions in the FY 2028 IPPS proposed rule, which the CDC timeline expects in April 2027. Wait for that rule before modeling impact.
Book a Demo. See how AutoPilot and CoPilot handle your own charts, with the documentation passage behind every code: book a demo .
Sources
- CDC NCHS, September 15-16, 2026 topic packet
- CDC NCHS, ICD-10-CM Committee Meetings and ICD-10 Coordination and Maintenance Committee
- CDC NCHS, ICD-10-CM Files ; CMS, ICD-10
- AHIMA, comments on the April 1, 2027 addenda, October 8, 2026
- ACDIS CDI Strategies, November 12, 2026 (secondary)