This year's annual ICD-9 update includes 171 new ICD-9 codes, according to a Centers for Medicare and Medicare Services official. The update also changes some code descriptors, including diabetes codes and codes from the mental-health chapter. The new codes go into effect Oct. 1. Although there are now annual ICD-9 code updates, CMS has proposed moving to a twice-yearly update as mandated in the Medicare Modernization Act, according to a CMS official. If this happens, the second update would most likely take effect in April and wouldn't include any hospital procedure code updates, the CMS source says. The new schedule could take effect as soon as next April, according to the proposal published in the May 18 Federal Register.