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:

  1. 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.
  2. 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.