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Annual ICD-10 and Quarterly CPT/HCPCS Code Updates (UMR)
Effective date
Oct 1, 2026
Identified
Oct 3, 2026
Summary
UnitedHealthcare's UMR medical policy update bulletin for October 2026 says the annual ICD-10 and quarterly CPT/HCPCS code changes took effect October 1, 2026 across its medical and drug policies. The billing team needs to add the new CPT, HCPCS and ICD-10 codes to charge entry, stop using the codes that were removed, and update the revised descriptions. The bulletin lists the code changes but does not state any coverage decisions beyond the policies it updates, so the practice should check each updated policy before billing the new codes.
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What to do
Action · 10 steps
01Already effective October 1, 2026 (elapsed; check the current UMR policy for each code before billing).
02Billing team, in charge entry and the charge master: add the new codes and retire the removed ones.
03Add CPT codes 1095T, 1104T, 1069T, 1070T, 1071T, 1080T, 1091T, 1088T, 1100T, 1101T, 1057T through 1061T, 0663U, 0668U, 0670U through 0677U, 0678U, 0679U, 0682U, 0683U, 0686U, 0688U, 0689U, 0693U, 0695U, 0696U and 0697U.
04Add HCPCS Q5173, J1757, J1818 and L8697.
05Add ICD-10 codes D69.11, D69.19, F64.A, Z87.8901, Z87.8902, Z87.8903, Z87.8904, Z87.8909, Z87.893, M86.8X51, M86.8X52, M86.8X59, M86.8X61, M86.8X62, M86.8X69, M86.8X71, M86.8X72, M86.8X79, M86.8X89, the O00 and O31 pregnancy codes listed in the bulletin, I42.00, I42.01, I42.09, I42.81, I42.89, I47.22, I49.81, I49.82, I49.89, and QA1.790, QA1.791, QA1.792, QA1.798.
06Stop using the removed codes: CPT 0585U and 0556U, and ICD-10 D69.1, Z87.890, M86.8X5 through M86.8X8, I42.0 and I49.8.
07Update the descriptions for CPT 0894T, 0895T and 0896T, which the bulletin revised.
08Before billing a new code, review the updated UMR medical policy named in the bulletin, such as Lower Extremity Endovascular Procedures, Gender Dysphoria Treatment, Sudden Cardiac Arrest and Sudden Cardiac Death Risk Assessment, or Breast Cancer Screening, for its coverage and documentation rules.
09Providers and front desk staff: tell them which new codes apply to the services they order.
10Watch for the next quarterly CPT/HCPCS update from UMR.
Codes mentioned
Q5173J1757J1818L8697D69.11D69.19D69.1F64.AZ87.8901Z87.8902Z87.8903Z87.8904Z87.8909Z87.893Z87.890M86.8X51M86.8X52M86.8X59M86.8X61M86.8X62M86.8X69M86.8X71M86.8X72M86.8X79M86.8X89M86.8X5M86.8X6M86.8X7M86.8X8O00.121O00.122O00.129O00.131O00.132O00.139O00.31O00.32O00.41O00.42O00.511O00.512O00.519O00.521O00.522O00.529O31.40X0O31.40X1O31.40X2O31.40X3O31.40X4O31.40X5O31.40X9O31.41X0O31.41X1O31.41X2O31.41X3O31.41X4O31.41X5O31.41X9O31.42X0O31.42X1O31.42X2O31.42X3O31.42X4O31.42X5O31.42X9O31.43X0O31.43X1O31.43X2O31.43X3O31.43X4O31.43X5O31.43X9I42.00I42.01I42.09I42.81I42.89I47.22I49.81I49.82I49.89I42.0I49.8
Original notice
Annual ICD-10 and Quarterly CPT/HCPCS Code Updates (UMR)
uhcprovider.com · Always check the source before changing claims.
Related changes
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Related policy hubs
UnitedHealthcare policiesPathologyOncologyCardiologyOB-GYNGeneticsHematologyPain ManagementVascular SurgerySleep MedicinePharmacyEndocrinologyCode Q5173Code J1757Code J1818Code L8697Code D69.11Code D69.19Code D69.1Code F64.ACode Z87.8901Code Z87.8902Code Z87.8903Code Z87.8904Code Z87.8909Code Z87.893Code Z87.890Code M86.8X51Code M86.8X52Code M86.8X59Code M86.8X61Code M86.8X62Code M86.8X69Code M86.8X71Code M86.8X72Code M86.8X79Code M86.8X89Code M86.8X5Code M86.8X6Code M86.8X7Code M86.8X8Code O00.121Code O00.122Code O00.129Code O00.131Code O00.132Code O00.139Code O00.31Code O00.32Code O00.41Code O00.42Code O00.511Code O00.512Code O00.519Code O00.521Code O00.522Code O00.529Code O31.40X0Code O31.40X1Code O31.40X2Code O31.40X3Code O31.40X4Code O31.40X5Code O31.40X9Code O31.41X0Code O31.41X1Code O31.41X2Code O31.41X3Code O31.41X4Code O31.41X5Code O31.41X9Code O31.42X0Code O31.42X1Code O31.42X2Code O31.42X3Code O31.42X4Code O31.42X5Code O31.42X9Code O31.43X0Code O31.43X1Code O31.43X2Code O31.43X3Code O31.43X4Code O31.43X5Code O31.43X9Code I42.00Code I42.01Code I42.09Code I42.81Code I42.89Code I47.22Code I49.81Code I49.82Code I49.89Code I42.0Code I49.8