2025 ICD-10-CM Updates for Aesthetic Practices

The 2025 (FY2025) ICD-10-CM update took effect October 1, 2024, for dates of service through September 30, 2025, and added 252 codes, deleted 36 and revised 13. For aesthetic and dermatology practices, the changes that matter most were new obesity class codes, new codes for lichen planopilaris and frontal fibrosing alopecia, a split of "other pruritus", and a new code for insufficient health insurance coverage. The FY2025 set has since been replaced: use the FY2026 set for dates of service from October 1, 2025 to September 30, 2026, and the FY2027 set from October 1, 2026.

L66.1 (lichen planopilaris) and L29.8 (other pruritus) stopped being complete codes on October 1, 2024; a claim that still uses them is invalid for later dates of service.

Sources checked October 14, 2026 · Prepared by Prospyr. No certified-coder or clinician review is claimed. ICD-10-CM is maintained by CDC's National Center for Health Statistics; use the code set in effect on the date of service.

What changed, in plain terms

Obesity by class. E66.811-E66.813 let the provider record obesity class directly. The obesity diagnosis must come from the patient's provider. A BMI code (Z68.-) may be taken from documentation by other clinicians, such as a dietitian, but it is reported only as a secondary code. This matters for practices running medical weight-management programs.

Hair loss. L66.1 became a subcategory with four codes. A patient with frontal fibrosing alopecia is coded L66.12 when the clinician documents that diagnosis. Use the unspecified code (L66.10) only when the record does not say which type.

Pruritus. L29.8 split into L29.81 (cholestatic pruritus) and L29.89 (other pruritus). Unspecified pruritus remains L29.9. Pick the code that matches what the clinician documented.

Social determinants of health (SDOH). Z59.7 split into Z59.71 (insufficient health insurance coverage) and Z59.72 (insufficient welfare support).

How SDOH Z codes may be used

The ICD-10-CM Official Guidelines say:

• SDOH codes (categories Z55-Z65) should be assigned when the information is documented, and as many as needed to describe the documented social problems or risks.
• Unlike most diagnoses, SDOH codes can be based on documentation from clinicians other than the patient's provider, such as nurses, social workers or case managers, if it is in the official medical record.
• Patient self-reported information can support an SDOH code when a clinician or provider signs off on it and incorporates it into the record.
• SDOH codes are reported only as secondary diagnoses.
• Documentation has to show a real problem or risk. The guidelines' example: merely living alone does not support Z60.2 (problems related to living alone) without documentation of a risk or unmet need for help at home.

Under the AMA's office E/M guidelines, a diagnosis or treatment significantly limited by social determinants of health is one example of moderate risk in medical decision making. That applies only when the record shows how the social factor changed management; adding a Z code does not raise a visit level by itself.

What changed after FY2025

• FY2026 (October 1, 2025): another annual update, followed by an April 1, 2026 update. It included a large expansion of non-pressure chronic ulcer codes (L97, L98.4 and new site-specific codes). Practices that do wound care should review those changes against the current files.
• FY2027 (October 1, 2026): the current code set as of this update.

Each October, load the new code set into your charting and billing systems, remove deleted codes from templates and superbills, and check that the codes your team uses most are still complete (billable) codes.

A short checklist

• Confirm which ICD-10-CM year applies to the date of service.
• Replace any code that became a subcategory (for example, L66.1 and L29.8) with a complete child code.
• Document the specific diagnosis: type, site and laterality where the code asks for it.
• Record SDOH information where it affects care, with clinician sign-off on patient-reported answers.
• Report SDOH codes as secondary diagnoses only.

Prospyr supports charting, digital intake, inventory and practice operations for aesthetic practices. It does not suggest diagnosis codes or submit insurance claims; practices that bill insurance heavily need a separate claims solution.

Sources

• ICD-10 code files by fiscal year (CMS)
• ICD-10-CM Official Guidelines for Coding and Reporting FY 2025 (CMS)
• CDC ICD-10-CM browser tool
• 2025 ICD-10-CM code updates: 252 new, 36 deleted, 13 revised (Wolters Kluwer)
• New ICD-10-CM codes for 2025, including obesity classes (SMFM)
• 2025 ICD-10 updates, including Z59.71 (ACAAI)
• FY2025 dermatology code changes, L29.8 and L66.1 (Podiatry Management)
• SDOH and E/M risk (Find-A-Code)