ICD-10-CM Proposal Submission Guidance

Purpose

Find detailed instructions to help you prepare a proposal for the International Classification of Disease, tenth revision, Clinical Modification (ICD-10-CM). Learn what details are important to include in preparing a proposal.
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Overview

Members of the public, representatives from the private sector, and those in government can submit proposals. The committee must receive proposals before the submission deadline for the next scheduled meeting.

Updated guidance

Proposal guidance has changed as of April 23, 2026.

Ultra-rare and genetic conditions

We are actively working to develop organizing principles to guide classification of ultra-rare and genetic conditions in ICD-10-CM. During this time, we are not accepting new proposals for these conditions.

We anticipate resuming new proposal submissions on these topics to follow the newly established principles for the March 2027 C&M Meeting. You can find more information in the March 17–18, 2026, meeting materials.

Proposal development guidance

Complete the proposal template to provide a detailed description of the proposed new code(s) or revision(s), including a clear explanation of the anticipated benefits and the specific health information gap the change is intended to address.

Do not include healthcare reimbursement or health insurance coverage issues as they are not considered in ICD-10-CM code maintenance decisions.

The proposal must include information in each section of the proposal template provided below. This includes the known information on four key characteristics as well as a two-page detailed description of the request. Each section of the proposal template is further described below. The four key characteristics you will describe in the proposal include—

  • Clinical
  • Patient encounter
  • Statistical/public health
  • Technical

Support all content with appropriate citations from peer-reviewed medical and scientific literature.

Use the following resources to prepare your proposal:

Submitting your proposal

Send your completed proposal template as a single document to nchsicd10cm@cdc.gov.

Proposal contents

In addition to the detailed description and four characteristics, all proposals must include—

  • Proposal topic
  • Submitter name and organization
  • Primary point of contact and email address
  • Secondary point of contact and email address, if applicable

Include medical/scientific description of the condition with detailed clinical reasoning that explains why the new code or change is necessary. In this section of the template, include for example—

  • The clinical definition and description of the condition, including factors that cause it and associated clinical signs and symptoms
  • The clinical validity and utility of assigning a unique code for the condition
  • Scientific information on the prevalence and incidence of the condition
  • Appropriate citations for this information from peer-reviewed medical and scientific literature

Consider the following questions to help determine what clinical characteristics to describe in this section of the template:

  • Is the condition medically, scientifically well defined?
  • Is the cause of the condition known?
    • If so, with what degree of certainty at the present time?
  • What is the clinical impact of a new code?
    • For example, how will the requested new code affect clinical care or the course of patient care?
    • Note: Reimbursement, insurance, and payor issues are not included in the proposal.

Recognizing the accuracy of ICD-10-CM code assignment depends on how and where the condition is documented in the health record. Without disclosing any personal health record information, provide information in this section of the template on how this condition is likely 1) documented in the health record, 2) by whom, and 3) what type of clinical documentation would support assigning a new code.

For example, you should note if this is a diagnosis that will be documented by an attending healthcare provider as an assessment or impression, as part of a problem list or a regular progress note, or in a discharge summary, etc.

Do not

  • Submit any portion of a health record
  • Disclose any personal health information in your submission

Describe how the condition is currently tracked/reported and where you suggest it should be placed within the ICD-10-CM classification structure, For example, in this section of the template—

  • List or provide the range of ICD-10-CM codes currently used to report the condition
  • Suggest where the new condition should be placed and identify any additional related categories or subcategories within ICD-10-CM
  • Describe how the proposal aligns with the structure and conventions of the ICD-10-CM classification system

Consider the following questions to help determine what statistical or public health characteristics to describe in your submission:

  • How is the condition identified and reported now?
  • Where should a new code be placed within ICD-10-CM?
    • What is the reasoning for this placement?

If you know whether this condition is partially captured in some way now, please provide more information. To help guide your response, consider including the following technical characteristics in this section of the template:

  • Is the condition currently included in another data standard or elsewhere in electronic health record systems?
    • If so, what standard (or where) and how is it organized or labeled?
    • If similar data exist, how would the proposed ICD-10-CM code be different from but align with that data?
  • Do you have any information about any terms, definitions, or technical specifications relevant to the proposed change?

In the detailed proposal section of the template, describe the new code(s) or change(s) you wish to request and the benefits of this change as well as the current information gap. This section of your submitted document should be no more than two pages and should include appropriate citations from peer-reviewed medical and scientific literature.

Checklist

Please be sure that you have provided the requested information in each section of the proposal template. Ensure that you have—

  1. Identified a specific proposal topic and the submitter's name and organization with a primary point of contact.
  2. Described the condition with clinical rationale explaining why the change is necessary.
  3. Provided information on patient encounter documentation characteristics.
  4. Described how the condition is currently tracked and suggested ICD-10-CM placement.
  5. Included technical characteristics, to the extent known.
  6. Completed all sections of the template, including all four characteristics.
  7. Described the proposed change and the reason this is needed in no more than two pages.
  8. Once you have completed all sections of the proposal template, email your completed proposal as a single document to nchsicd10cm@cdc.gov.
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Content Source:
National Center for Health Statistics