Referencing a Codes That Matter study, CMS developed a breakdown of common codes based on specialty and released it with the following two warnings:

  1. “The codes most frequently used by your practice will vary based on geographic location, patient population, payer mix, and other differentiating factors.”
  2. Even though this study shows unspecified codes as being common, practitioners should absolutely (positively, definitely) consider codes that have a greater degree of specificity first and foremost.

Without further ado, below are the common codes associated with PT, according to CMS. (I took the liberty of removing the unspecified codes for those that allow specific laterality.)

Pain in Joint
M25.511 Pain in right shoulder
M25.512 Pain in left shoulder
M25.521 Pain in right elbow
M25.522 Pain in left elbow
M25.532 Pain in left wrist
M25.551 Pain in right hip
M25.552 Pain in left hip
M25.561 Pain in right knee
M25.562 Pain in left knee
M25.571 Pain in right ankle and joints of right foot
M25.572 Pain in left ankle and joints of left foot
M25.579 Pain in unspecified ankle and joints of unspecified foot
M25.50* Pain in unspecified joint
Pain in Limb
M79.601 Pain in right arm
M79.602 Pain in left arm
M79.604 Pain in right leg
M79.605 Pain in left leg
M79.609 Pain in unspecified limb
M79.621 Pain in right upper arm
M79.622 Pain in left upper arm
M79.631 Pain in right forearm
M79.632 Pain in left forearm
M79.641 Pain in right hand
M79.642 Pain in left hand
M79.644 Pain in right finger(s)
M79.645 Pain in left finger(s)
M79.651 Pain in right thigh
M79.652 Pain in left thigh
M79.661 Pain in right lower leg
M79.662 Pain in left lower leg
M79.671 Pain in right foot
M79.672 Pain in left foot
M79.674 Pain in right toe(s)
M79.675 Pain in left toe(s)

Want to view all the common codes? Check out the full list here. Keep in mind that this list is inherently limited because for therapy, it focuses predominantly on pain, even though you should always code for the underlying condition that is causing the pain whenever possible. What codes do you think are most common in your practice?

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