Most Common ICD-10 Codes for PTs
Here are the most common ICD-10 codes for physical therapists, according to CMS. But before you dive right in, heed these two warnings:
- Code use varies based on provider location, patient population, and payer mix—among other factors. Therefore, not all of these codes will be relevant to you.
- Even though many of the most common codes for physical therapists are unspecified codes, you should always try to use codes that have a greater level of specificity.
Now, without further ado, the codes themselves (and to help you adhere to warning number two above, we’ve taken the liberty of replacing unspecified codes with those that allow for specific laterality, where applicable):
Pain in Joint
|M25.511||Pain in right shoulder||M25.552||Pain in left hip|
|M25.512||Pain in left shoulder||M25.561||Pain in right knee|
|M25.521||Pain in right elbow||M25.562||Pain in left knee|
|M25.522||Pain in left elbow||M25.571||Pain in right ankle and joints of right foot|
|M25.531||Pain in right wrist||M25.572||Pain in left ankle and joints of left foot|
|M25.532||Pain in left wrist||M25.579||Pain in unspecified ankle and joints of unspecified foot|
|M25.551||Pain in right hip||M25.50*||Pain in unspecified joint|
Pain in Limb
|M79.601||Pain in right arm||M79.644||Pain in right finger(s)|
|M79.602||Pain in left arm||M79.645||Pain in left finger(s)|
|M79.604||Pain in right leg||M79.651||Pain in right thigh|
|M79.605||Pain in left leg||M79.652||Pain in left thigh|
|M79.609||Pain in unspecified limb||M79.661||Pain in right lower leg|
|M79.621||Pain in right upper arm||M79.662||Pain in left lower leg|
|M79.622||Pain in left upper arm||M79.671||Pain in right foot|
|M79.631||Pain in right forearm||M79.672||Pain in left foot|
|M79.632||Pain in left forearm||M79.674||Pain in right toe(s)|
|M79.641||Pain in right hand||M79.675||Pain in left toe(s)|
|M79.642||Pain in left hand|
This list is inherently limited because for therapy, it focuses heavily on pain. However, as we mentioned in Part 1 of this guide, you should code for the underlying condition causing your patients’ pain whenever possible. For the entire list of common codes, click here.
What ICD-9 codes are most common in your practice? Have you found their ICD-10 equivalents yet? Check out this article for instructions on how to do just that.