Physical Therapy Coding Cheat Sheet – Your Definitive Guide to Physical Therapy ICD-10 Coding
Most physical therapy private practices use the same, or similar set of diagnosis and treatment codes in outpatient physical therapy practice. Physical therapy billing requires a careful selection of ICD-10 and CPT codes to maximize reimbursement. Physical therapy coding is a critical part of every clinic’s cashflow.
We’ll focus on physical therapy ICD-10 guidelines in this article. If you’re more interested in treatment codes, check out the resource on the most common physical therapy cpt codes.
ICD-10 – A New Era of Specificity in Physical Therapy Coding
ICD-10 codes represent diagnosis, and are the foundation of physical therapy coding. These codes are used by providers and physical therapy coders to classify ailments and injuries. This is a prerequisite for compliant documentation and claim reimbursement from payers.
ICD-10 is a vast and, to many, an overwhelming system – so much so that there are physical therapy coding companies who specialize in creating properly coded claims for practices.
ICD-10 was endorsed by the World Health Assembly in May 1990 and has been in use in WHO Member States beginning in 1994. ICD-10 went into effect for the U.S. healthcare industry on Oct. 1, 2015, after a series of lengthy delays.
While ICD-10 can be confusing, it is a superior system, especially for physical therapy coding largely due to its diagnostic specificity. In other words, the clinician can (and is now expected to) get really specific about the diagnosis of the patient.
Specific improvements in physical therapy related diagnosis codes include expanded injury codes, combined codes, laterality codes and greater specificity in code assignment.
Download the Physical Therapy Coding Cheat Sheet – The First of its Kind in the Industry
With the complexity and confusion surrounding ICD-10, the staff at In Touch Billing has put together a physical therapy coding cheat sheet, geared specifically for ICD-10.
This is a list of ICD-10 codes commonly used in physical therapy coding. We have analyzed the 68,000 + ICD-10 codes, and have identified approximately 11,000 codes that are relevant to physical therapy billing and coding.
In Touch Billing has spent over 100 hours to organize this document, and we’re making this available to the entire physical therapy community to show you how awesome we are (and to earn your business if you ever look for a physical therapy emr, physical therapy billing software, or physical therapy billing service).
We have accounted for every imaginable condition treated by physical therapists, which is why this document contains almost 11,000 line items.
- Spasm muscle
- Muscle weakness (general)
- Pain joint shoulder region
- Pain joint pelvis & thigh
- Muscle disuse atrophy
- Stiffness joint neck and shoulder region
- Abnormality of gait
- Lumbar disorders
- Pain joint ankle & foot
- Abnormal posture
- Pain thoracic spine
- Plantar fibromatosis
- Pain joint hand
- Pain joint upper arm
- Lumbar sprain
- Stiffness joint neck, multiple sites
- Shoulder region disorders
- Muscle/ligament fascia disorders
- Dizziness & giddiness
- Abdominal tenderness
- Chronic pain
- Degenerative lumbar intervertebral disc problems
- Facial weakness
- Tension headache
and much more….
Click the button below to gain access to this list.
Please note that this list is not exhaustive and should not be used exclusively; accompany them with the ICD-10-CM Official Guidelines, tables, and index. You should certainly know which ICD-1o codes are specific to physical therapy and rehabilitation (so you can bill them), but you should also know which ICD-10 codes are truncated / unspecified / invalid (so you can avoid them). That’s why we have created another list for you….
Introducing The Dreaded Truncated / Invalid / Unspecified ICD-10 Codes for Physical Therapy – Avoid Billing these Codes at all Costs
Clinicians aren’t physical therapy coders, and shouldn’t be expected to know the ins and outs of the complex world of physical therapy billing and coding. All ICD-10 codes must be documented to the highest level of specificity. Truncated / invalid / unspecified ICD-10 codes will result in rejections. That’s why we did something significant for our readers. The ICD-10 certified coders at In Touch Billing, the sister company of In Touch EMR, have analyzed all the ICD-10 codes, and put together a comprehensive tool. We have created a list of truncated / invalid / unspecified ICD-10 codes to help physical therapy providers, billers and coders. We went to great lengths to create this, by reviewing every single ICD-10 code, we didn’t just search for ‘unspecified’ codes and give you that list. We worked much harder than that. Click the button below to gain access to the entire list of ICD-10 codes to avoid.
Here’s a summary of the data you can expect in this groundbreaking list.
The asterick * indicates unspecified / invalid / truncated ICD-10 codes that must be avoided.
- The ICD-10 C Code Family – Neoplasms (C00-D49) – 448 ICD-10 codes *
- The ICD-10 D Code Family – Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) – 189 ICD-10 codes *
- The ICD-10 F Code Family -Mental, Behavioral and Neurodevelopmental disorders (F01-F99) 336 ICD-10 codes *
- The ICD-10 G Code Family – Diseases of the nervous system (G00-G99) – 292 ICD-10 codes *
- The ICD-10 H Code Family – Diseases of the eye and adnexa (H00-H59) – 1272 ICD-10 codes *
- The ICD-10 I Code Family – Diseases of the circulatory system (I00-I99) – 560 ICD-10 codes *
- The ICD-10 J Code Family – Diseases of the respiratory system (J00-J99) – 157 ICD-10 codes *
- The ICD-10 M Code Family – Diseases of the musculoskeletal system and connective tissue (M00-M99) – 3772 ICD-10 codes *
- The ICD-10 N Code Family – Diseases of the genitourinary system (N00-N99) – 221 ICD-10 codes *
- The ICD-10 R Code Family – Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) – 196 ICD-10 codes *
- The ICD-10 S Code Family – Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) – 8306 ICD-10 codes *
- The ICD-10 T Code Family – 561 ICD-10 codes *
- The ICD-10 V Code Family – 1471 ICD-10 codes *
- The ICD-10 W Code Family – 521 ICD-10 codes *
- The ICD-10 X Code Family – 202 ICD-10 codes *
- The ICD-10 Y Code Family – 598 ICD-10 codes *
- The ICD-10 Z Code Family – 354 ICD-10 codes *
Total – 19456 ICD-10 codes
Non specific codes will result in claim rejections at the clearinghouse or payer level. If this happens, clinicians / billing will need to re-code to a high level of specificity and resubmit.
This includes codes from the C, D, F, G, H, I, J, M, N, R, S, T, V, W, X, Y, Z family of ICD-10 codes that fall into the truncated / invalid / unspecified category and must be avoided.
The easiest way to simplify and streamline the coding aspect of documentation is to utilize an EMR that has built in ICD-10 technology to help clinicians choose the best (and most specific) codes.
In Touch EMR not only includes extensive ICD-10 technology, but is backed by an expert team of ICD-10 certified physical therapy coders at In Touch Billing.
Physical therapists and clinic owners benefit with a compliant, current system, with a qualified team to support it.
In Touch EMR is a fully customizable EMR, certified by the Federal Office of the National Coordinator so that physical therapists can rest assured that they are using the most compliant and secure system possible.
In Touch Billing, which is an add-on service with In Touch EMR, has helped thousands of therapists get higher reimbursements at well below average costs for billing services.
Next Step – Schedule a Demo of In Touch EMR and In Touch Biller Pro
If you have any questions, please click here to schedule a demo of In Touch EMR to learn more.
If you can’t wait, here is a quick, 10 minute walkthrough of the In Touch EMR software.
Here is a 10 minute demo of the In Touch Biller Pro software – the fully integrated revenue cycle management and billing software from In Touch EMR.
Need More Information about In Touch EMR? Contact Us
In Touch EMR is a fully integrated scheduling, documentation and billing software for physical therapy practices. It is a simple and user friendly web-based, ICD-10 and HIPAA compliant EMR, and it offers customizable templates for notes, the ability to attach files, electronic signatures, and the ability to track progress notes, treatment plans, and assessments.
In Touch EMR has grown to over 1000 clients, our company / founders have been mentioned on CNN, Forbes, Huffington Post, Amazon, received the prestigious ONC certification, 2015 and 2016 PQRS registry designation, integrated with Microsoft’s cutting edge patient portal technology and initiated groundbreaking healthcare partnerships with companies like Novartis. All of this is possible thanks to clients across the country, who have embraced In Touch EMR.
In Touch EMR is featured on our HIPAA compliant hosting partner (Amazon Web Services) website along with other industry leaders such as the Cleveland clinic, Nexttech, Saint Mary’s regional medical center and UCLA health.
SIMPLE, TRANSPARENT PRICING MODEL
At In Touch EMR, we charge a flat fee per licensed clinician (no hidden fees or surprises) and it includes everything, unlimited claims and notes and infinite custom template creation. We are also a CMS recognized PQRS registry, we automate the reporting of PQRS and Functional Limitation G codes and provide automatic alerts for plan of care expirations, authorizations, progress note reminders and KX modifier alerts.
Clients also get a self-paced video training program on how to get up and running, custom documentation template builder, iPad app – one touch document import, Instant Intake iPad app, unlimited patient manager and patient portal.
Every license unlimited ongoing support (phone / email / live chat), billing software integration, unlimited appointments, unlimited documentation, unlimited document uploads and unlimited electronic faxing.
OFFICE OF THE NATIONAL COORDINATOR CERTIFIED ELECTRONIC HEALTH RECORD TECHNOLOGY
We are a premier vendor in the rehabilitation space, and on the prestigious, certified Health IT Product List, which is a division of the office of the National Coordinator for Health Information Technology, a division of the Department of Health and Human Services.
Very few vendors can make this claim, and they generally won’t bring this up (in some cases, out of ignorance) mostly because this is not a mandatory certification, it is optional and requires a significant investment of time and effort. This certification is a sign of our commitment to a HIPAA compliant, secure and stable EMR system for your clinic.
If you ever get audited, the fact that you are using ONC-certified EHR technology (CEHRT) will work in your favor. CMS looks favorably on the use of CEHRT since HHS is trying to encourage the adoption of CEHRT amongs providers nationwide as part of a long term push towards electronic documentation and interoperability between EMR systems. Your practice can state that it carefully vetted and selected “a rehabilitation-specific vendor that passed all of the ONC HIT 2014 Edition EHR Certification criteria required to satisfy the Base EHR definition”
Since In Touch EMR has been very proactive at staying at the forefront of emerging guidelines for EMR vendors, you are assured higher quality, higher security and more compliance with CMS and other payer regulations.
For more information about the ONC, please visit:
In Touch EMR is one of the only EMR vendors in the rehabilitation space to pass all the 2014 Edition EHR Certification criteria required to satisfy the Base EHR Definition as stated by the Office of the National Coordinator for Health Information Technology, as listed here:http://www.healthit.gov/sites/default/files/pdf/BaseEHR_8-18-12_Final.pdf
In Touch EMR is on the Certified Health IT Product List (CHPL) website.
PRAISE FROM THOUSANDS OF SATISFIED CLINICS ACROSS THE UNITED STATES
“In Touch EMR has emerged as a comprehensive, customizable EMR solution for our growing organization. Support is always there when we need it, options to customize options to match our workflow are endless, clinicians find it simple and easy to use, front desk and billing love the integration between documentation and claims and compliance is built-in. This is exactly what we needed and it has boosted our efficiency. Couldn’t have asked for more. In Touch EMR is a leader in web-based EMR for our practice. Thank you!”
Julie Edelman PT, DPT – Avanti Therapy
“Moving to In Touch EMR was a process of adjustment, but it was worth it, for several reasons. Not only has the staff at In Touch EMR been proactive in adding new features and responding to support calls and streamlining our billing processes, they have been understanding, professional, polite and patient. The ability to create our own documentation templates, generate professional reports on demand and submit claims to billing with one click has allowed us to streamline our practice. The billing software is extremely versatile – I can review number of claims sent / on hold, payer breakdown, charges per visit and collections per visit. Our biller is able to pull up detailed reports, exactly the way we want. My front desk staff has the ability to track authorizations and create progress note alerts, physician prescription alerts and fax reports to physicians with the click of a button in In Touch EMR. My management is now exploring analytics to identify areas of growth and efficiency and expect to drive our practice further with analytic insights. Best of all, the transition for our entire staff was streamlined and consistent and help was readily available. I like that we are able to talk to someone whenever we need to. If you are looking for a powerful, reliable, and responsive team to help you implement EMR and billing software to grow your practice, look no further than the team at In Touch EMR. We support this therapist owned EMR company wholeheartedly.”
Matthew S. Fischer, MSPT – Fischer Physical Therapy
“In my 30+ years as a compliance auditor, author and instructor, I have yet to see an EMR and billing software as comprehensive as In Touch EMR. If you are looking for compliant ICD-10 documentation, and a ‘gold standard’ that can survive auditing, get In Touch EMR. A well defined workflow for the front desk, clinicians, billers and coders makes this a one-stop shop for quick, compliant documentation and flawless billing. I’m impressed with their HIPAA compliance, PHI protection and data breach prevention protocols. The front desk automation (certification alerts, patient portal, birthday reminders, e-newsletters) and clinician automation (progress note and reevaluation countdown, autotext technology, flowsheet templates, tasks and messages) are sufficient to set them apart. They didn’t stop there. The billing automation (claim cleanser, automatic transmission to billing, CCI edits – modifier 59 automation, autopost ERAs) and the administrator functions (access controls, audit logs, time tracking, productivity metrics) result in an incredible EMR and billing software combination for all clinicians. It’s a no brainer – forget the hype from other products and get In Touch EMR”
Cheryl House RMC, CHI Compliance Auditor, Author, Coder and Instructor at Illinois Valley Community College
“I was looking for a Practice Management Software that combined both documentation and billing platform systems that work in unison. I had previously tried more complicated systems that made me exhausted at the end of the day. In Touch EMR and In Touch Biller Pro represent a united and unified package that helps the private practice clinician govern a practice. It’s easy to use, it is concise, and it has a plenty of analysis variables to study.”
Sammy K. Bonfim PT – Rehabilitation & Performance Center
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Schedule a Demo of In Touch EMR Now
At In Touch EMR, we charge a flat fee per licensed clinician (no hidden fees or surprises) and it includes everything, unlimited claims and notes and infinite custom template creation. We are also a CMS recognized PQRS registry, we automate the reporting of PQRS and Functional Limitation G codes and provide automatic alerts for plan of care expirations, authorizations, progress note reminders and KX modifier alerts. Schedule a demo to see why practices across the country are switching to In Touch EMR.