The 50 most commonly used ICD-10 and CPT codes for physical therapy
Anyone who does medical coding on a regular basis knows the value of a cheat sheet. At SuperBill, our mission is to save you time and money. That’s why we’ve built a list of time-saving ICD-10 and CPT codes for physical therapy, or PT.
According to the American Physical Therapy Association, over 300 million physical therapy sessions happen each year. And the profession is expected to grow 17% by 2031. That’s A LOT of medical coding!
Save yourself some hassle by quickly scanning this list. For physical therapy CPT codes, skip to the bottom section. For physical therapy ICD-10 codes, just keep reading.
What Are Physical Therapy ICD-10 Codes?
The International Classification of Disease, 10th Revision (ICD-10) is a universal series of diagnosis codes physical therapists use to identify ailments. They are especially useful for billing, because they standardize the terms used by both medical providers and insurers. The full list of ICD-10 codes on CMS.gov is over 1,000 pages long. So, medical coders often refer to cheat sheets like this one to increase their efficiency with PT ICD-10 codes.
In 2015, the medical community, including physical therapists, transitioned from ICD-9 to ICD-10. Now, the newest revision of the International Classification of Diseases, ICD-11, is on its way. While it has been implemented in some countries, the U.S. hasn’t implemented ICD-11. There is no announced date for ICD-11 to take effect, so continue using ICD-10 codes until further notice. ICD-9, however, is out of date and will not be accepted by insurers.
Common ICD-10 Codes for Physical Therapy
Many common ICD-10 Codes for PT come from Section M of the ICD-10, “Diseases of the musculoskeletal system and connective tissue.” Search the following table for some of the most commonly used PT ICD-10 codes.
Is there a common physical therapy ICD-10 code that we left out? Let us know at support@thesuperbill.com and we’ll do our best to add it!
What are Physical Therapy CPT Codes?
Current Procedural Terminology (CPT) codes are similar to ICD codes in that they both give providers and insurers a uniform language for medical occurrences. However, the difference between CPT and ICD codes is that CPT codes describe medical services rendered. Where an ICD code identifies a diagnosis, a CPT code marks the procedure or prescription issued in response to a diagnosis.
For instance, suppose you treat a physical therapy patient with low back pain. The ICD-10 code for the low back pain diagnosis would be M54.5. If you administer a hot/cold pack for the pain, the CPT code for that treatment would be 97010. CPT codes are generally numeric (with a few exceptions) as opposed to the alphanumeric system of ICD codes.
How to Bill Time Units in PT CPT Codes
Note that many of these procedures are performed multiple times per session. To bill correctly, it’s essential that you understand time units and the 8-minute rule. The standard unit of time for the AMA is 15 minutes. That means that for billing purposes, an hour-long session of manual therapy techniques would have four 97140 codes. (Since each code denotes one 15-minute segment of time.)
Procedures marked N/A are considered “non-timed” services and should be billed per service unit. For instance, if you perform an ultrasound, you will mark code 97035 only one time, regardless of how long it takes.
Common CPT Codes for Physical Therapy
Lists of CPT codes are harder to find for free than ICD codes. Many websites charge you for their cheat sheets and code-finders. SuperBill’s list of PT CPT codes however, is completely free. Access physical therapy CPT codes—from evaluations to therapeutic exercises and massage therapy CPT codes—here at any time.
Further Reading
For more general medical coding advice, check out our post on CPT and ICD-10 Coding Tips. If you’re an out-of-network provider looking for an easier way to explain OON billing, take a look at How to Explain Superbills and OON Reimbursement to Your Clients.
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About the Author
Harry is passionate about the power of language to make complex systems like health insurance simpler and fairer. He received his BA in English from Williams College and his MFA in Creative Writing from The University of Alabama. In his spare time, he is writing a book of short stories called You Must Relax.