So, ICD-10 is a tad more complex than ICD-9. Okay, it’s a lot more complex. In fact, compared to ICD-9, there are about 55,000 more codes in the new set. The good news, though, is that you’ll probably only ever use a handful of them. And one of the best way to prepare for the transition is to create a list of the new codes you know you’re going to need.

Unfortunately, though, identifying the ICD-10 equivalent of an ICD-9 code can be challenging. Because ICD-10 is significantly more specific than ICD-9, there are many instances in which a single ICD-9 code has several ICD-10 correlations. So while a straightforward crosswalking tool isn’t going to give you the most accurate code conversion, there is another way. To get started, download the complete Tabular List of ICD-10 codes here (click the ICD-10-CM PDF Format link under the 2014 release of ICD-10-CM section).

As a rehab therapist, you’ll mostly use chapters 13 (diseases of the musculoskeletal system and connective tissues) and 19 (injury, poisoning and certain other consequences of external causes). Start there, and use your PDF viewer's search functionality to look up a specific code―or at least to identify some potential ones. You also can perform a keyword search at or use this ICD-9 to ICD-10 conversion tool. However, as I mentioned above, these tools usually will not provide you with an exact match. Rather, they’ll suggest the least specific ICD-10 option, which pretty much defeats the purpose of the new code set. But these kinds of tools will give you a good place to start. Here’s an example: 719.46 (pain in joint, lower leg) is one of the most commonly used ICD-9 codes among PTs. If you enter this code into that conversion tool, you’ll get M25.569 (pain in unspecified knee) as a result. While this may be technically correct, it is most definitely not the right code to use. As a PT, you should at least know in which knee your patient is experiencing pain―and failing to code this very pertinent information may very well result in a claim rejection.

To find the most correct code, open the Tabular List and go to chapter 13, which is where all the M codes reside. Then, find M25.56 (the knee pain category) and read through the subsequent options that include laterality (i.e., M25.561: pain in the right knee and M25.562: pain in the left knee.) Additionally, if you can code for the specific condition that is causing your patient’s pain, even better. To continue with the above example, if you determine that your patient is suffering from patellar tendinitis, you would use either M76.51 or M76.52 (patellar tendinitis, right or left knee, respectively) instead.

While you’re browsing the new code set, pay close attention to the instructions at the top of each chapter and category. In some cases, you may need to apply an external cause code or a seventh character. For instance, at the beginning of chapter 13, you’ll see the following: “Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition.” In other words, if you know additional details about what caused your patient’s condition, you should account for them using supplemental external cause codes, which can be found in Chapter 20. (Please note, however, that there is no national requirement for external cause codes, so in most cases submitting them is optional.) If your knee pain patient developed his or her patellar tendinitis as a result of running on a treadmill, for example, you’d indicate that by adding the supplemental code Y93.A1 (activity, treadmill).

If you prefer your how-tos in step form, you’re in luck. Here’s how to find the correct ICD-10 code in four easy steps:

  1. Type the ICD-9 code you’d normally use into a conversion tool to get an ICD-10 code to use as a starting point.
  2. Review the Tabular List to determine if there are codes with greater levels of specificity available. (Be sure to pay attention to chapter and category headings for additional coding instructions.)
  3. If you can, code for the actual condition (e.g., patellar tendinitis) instead of the result (e.g., knee pain).
  4. If instructed to do so, use a pertinent external cause code, which can be found in chapter 20 of the Tabular List.

What are your top five most commonly used ICD-9 codes? Have you found their ICD-10 equivalents yet? If so, what advice do you have for other therapists compiling their lists? Share your thoughts―and questions―in the comments section below.

The PT’s Guide to Billing - Regular BannerThe PT’s Guide to Billing - 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 …

  • 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 …

  • How to Test ICD-10 Externally Image

    articleApr 29, 2014 | 3 min. read

    How to Test ICD-10 Externally

    Today, we’re tackling how to test ICD-10 externally. (We discussed testing internally yesterday. Click here if you missed it.) The point of testing is to ensure that—come the mandatory transition deadline—you, your processes, and your systems are all working in harmony so you get paid for doing what you do best: treating your patients. According to Carl Natale, editor of ICD10Watch and author of this article , proper testing should help you: “Verify that [your] practice can …

  • Beware of ICD-10 Shortcuts: The Case Against One-to-One Crosswalking Image

    articleFeb 24, 2015 | 7 min. read

    Beware of ICD-10 Shortcuts: The Case Against One-to-One Crosswalking

    ICD-10 is inherently more sophisticated and specific than ICD-9, but that doesn’t necessarily mean it’s more complicated. So, why are healthcare professionals pulling their hair out over the mandatory transition to these new codes? Because learning ICD-10 is like learning a new language. If we were going into this with a clean slate–like a newborn babe—perhaps it wouldn’t be so tough to learn the language. Unfortunately, though, the US healthcare industry has relied on ICD-9 codes for …

  • 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 …

  • Physical Therapy Billing for Beginners Image

    articleJul 26, 2019 | 7 min. read

    Physical Therapy Billing for Beginners

    Most physical therapists chose this profession to help people—not to become the world’s greatest biller. And yet, in order to stay in business long enough to truly make a difference for your patients, you’ve got to know how to make a profit—and that requires a solid understanding of PT billing. If you’re new to physical therapy, you might be feeling a little overwhelmed by the prospect, so below, we’ve provided some billing basics:  Codes ICD To properly …

  • History of ICD-10 Image

    articleFeb 17, 2015 | 5 min. read

    History of ICD-10

    If you haven’t heard of ICD-10 by now, you’ve probably been living under a rock . Though CMS has talked about the impending implementation of ICD-10 like a boy crying “Wolf!,” the days of false alarms are over—at least that’s what the experts are saying . That’s right: it’s finally happening, folks. And the mandatory transition to the new diagnosis code set will be here before we know it (even if it is 20 years late). Let’s …

  • Don’t Let ICD-10 and Direct Access Bug You Image

    articleAug 13, 2015 | 7 min. read

    Don’t Let ICD-10 and Direct Access Bug You

    Obviously, there’s been quite a buzz surrounding ICD-10; and providers throughout the country are making a tremendous effort to figure out exactly how the transition is going to affect us all . And just like a winged—and busy—bug that won’t stop whizzing past your ear, the noise isn’t likely to die down anytime soon. And that’s for good reason: the ICD-10 transition is a big one, and there are many factors rehab therapists have to consider when …

  • Will ICD-10 End the Paper Superbill? Image

    articleSep 8, 2015 | 2 min. read

    Will ICD-10 End the Paper Superbill?

    In a dark world filled with endless paperwork and thousands of billing codes, rehab therapy clinics need a hero. Many medical professionals would say their office hero is the paper superbill. It’s fast, convenient, and easy to use. But hold on to your spandex tights, because ICD-10 is coming—and it might just be the paper superbill’s kryptonite . Here’s why the ICD-10 paper superbill just doesn’t work: It’s longer. ICD-9 has around 13,000 codes, so your paper …

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