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?

Physical Therapist Salary Guide - Regular BannerPhysical Therapist Salary Guide - Small Banner
  • ICD-10 FAQ Part 4 Image

    articleNov 3, 2015 | 5 min. read

    ICD-10 FAQ Part 4

    Like the many Land Before Time sequels, the versions of our ICD-10 FAQ keep on-a-comin’. But—unlike those beloved dinosaur tales—I don’t anticipate 12 more versions (plus a TV series) will be necessary to cover what’s to come with ICD-10. Still, the questions continue to roll in—albeit a bit slower than they did a couple of months ago. However, most of the inquiries we’ve received in recent weeks have been super specific. That’s why, our most recent webinar—the …

  • 7 Scoops of 7th Character Sage Image

    articleAug 5, 2015 | 7 min. read

    7 Scoops of 7th Character Sage

    Seven dwarves; seven world wonders; 7-Up. These are all totally non-threatening—some might even say smile-inducing—associations with the number seven. ICD-10’s seventh character, on the other hand, has caused a lot of frowns—or, at the very least, furrowed brows—among those in the healthcare community. And that’s especially true for physical therapists. Here, I’ve compiled a list of seven seventh-character must-knows: 1. There’s no ICD-9 equivalent of the seventh character. ICD-9 caps its codes at five characters, meaning seventh …

  • A Farewell Ode to ICD-9 Image

    articleSep 30, 2015 | 2 min. read

    A Farewell Ode to ICD-9

    As the hours count down It’s hard to believe That we’ve finally made it To ICD-10 Eve Our journey to get here Hasn’t been without strife As the US has clung To ICD-9 for dear life Letting go can be hard And change can be tough But in the modern medical world ICD-9 just isn’t enough Unlike a fine wine That gets better with time ICD-9 has aged poorly— It’s way past its prime Sure, we’ll always …

  • ICD-10 and Your Claims: 7 Essential Must-Knows Image

    articleSep 14, 2015 | 7 min. read

    ICD-10 and Your Claims: 7 Essential Must-Knows

    As we’ve suggested in previous posts , one of the best ways to ensure your practice covers all of its ICD-10 prep work bases is to audit your processes and workflows. By doing so, you’ll identify all the ways you and your staff currently use and interact with ICD-9 codes. If you’ve done that, you’ve no doubt pinpointed one of the largest—and most obvious—ICD-9 touchpoints: your claims. Then, you probably asked yourself (or the almighty Google), “How …

  • The Final 48: Your Guide to ICD-10 Transition Day Image

    articleAug 31, 2015 | 5 min. read

    The Final 48: Your Guide to ICD-10 Transition Day

    For law enforcement officials, the 48 hours immediately following a crime are the most crucial. Why? Because if they haven’t found any leads, identified any suspects, or made any arrests by the time the two-day clock expires, their chances of cracking the case—and, in some cases, saving lives—dwindle significantly. And while ICD-10 isn’t exactly a life-or-death situation, those HIPAA-covered providers making the switch will be up against a similar make-it-or-break-it timeframe. The only difference—besides the whole crime …

  • ICD-10 Bootcamp: Coding Exercises for PTs, OTs, and SLPs Image

    webinarJul 30, 2015

    ICD-10 Bootcamp: Coding Exercises for PTs, OTs, and SLPs

    As the old saying goes, “Practice makes perfect.” But with the transition to ICD-10 kicking off in a little more than a month, there’s not a whole lot of practice time left. Before you know it, you’ll be taking the field for game time—and this is one game where you definitely can’t rely on talent alone. Looking for a way to get you and your staff members in ICD-10-coding shape—fast? Consider this your ICD-10 boot camp. In …

  • ICD-10 Talk with Dr. Heidi Jannenga: Why ICD-10? Image

    articleSep 4, 2015 | 1 min. read

    ICD-10 Talk with Dr. Heidi Jannenga: Why ICD-10?

    In the first video of our ICD-10 Talk video series, Dr. Heidi Jannenga provided a general overview of ICD-10 and how it differs from ICD-9. In this week’s video, Heidi details some of the limitations of ICD-9 and explains why the transition to ICD-10 is necessary. She also offers clarification on a common point of confusion: does the switch go by date of claim submission or date of service? Watch now to find out, and stay tuned …

  • This Week in PT News, March 28 Image

    articleMar 28, 2014 | 2 min. read

    This Week in PT News, March 28

    S. 2110 Vote The Senate is scheduled to vote on the Medicare cap this week, so it’s your last chance to contact your local representatives and ask them to vote “yes” for the Medicare SGR Repeal and Beneficiary Access Improvement Act (S. 2110). Find your senator’s contact information here . HR 4302 Vote Yesterday, the House of Representatives passed by voice vote a proposal (HR 4302) to delay for 12 months a scheduled 24% cut to Medicare …

  • ICD-10 Talk with Dr. Heidi Jannenga: What’s the Deal with Auto Insurances? Image

    articleOct 1, 2015 | 1 min. read

    ICD-10 Talk with Dr. Heidi Jannenga: What’s the Deal with Auto Insurances?

    In this edition of ICD-10 Talk, Dr. Heidi Jannenga explains why some payers aren’t required to make the switch to ICD-10 this week. Wondering which payers aren’t subject to the transition mandate? Watch now to find out, and stay tuned to the WebPT Blog for more great ICD-10 videos throughout the month.

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.