For Providers

The Top 50 Physical Therapy CPT Codes and ICD-10 Codes Cheat Sheet

Anyone who does medical coding on a regular basis knows the value of a cheat sheet. At SuperBill, our mission is to save you time and money. That’s why we’ve built a list of time-saving ICD-10 and CPT codes for physical therapy, or PT. 

According to the American Physical Therapy Association, over 300 million physical therapy sessions happen each year. And the profession is expected to grow 17% by 2031. That’s A LOT of medical coding! 

Save yourself some hassle by quickly scanning this list. For physical therapy CPT codes, skip to the bottom section. For physical therapy ICD-10 codes, just keep reading. 

What Are Physical Therapy ICD-10 Codes?

The International Classification of Disease, 10th Revision (ICD-10) is a universal series of diagnosis codes physical therapists use to identify ailments. They are especially useful for billing, because they standardize the terms used by both medical providers and insurers. The full list of ICD-10 codes on CMS.gov is over 1,000 pages long. So, medical coders often refer to cheat sheets like this one to increase their efficiency with PT ICD-10 codes. 

In 2015, the medical community, including physical therapists, transitioned from ICD-9 to ICD-10. Now, the newest revision of the International Classification of Diseases, ICD-11, is on its way. While it has been implemented in some countries, the U.S. hasn’t implemented ICD-11. There is no announced date for ICD-11 to take effect, so continue using ICD-10 codes until further notice. ICD-9, however, is out of date and will not be accepted by insurers. 

Common ICD-10 Codes for Physical Therapy

Many common ICD-10 Codes for PT come from Section M of the ICD-10, “Diseases of the musculoskeletal system and connective tissue.” Search the following table for some of the most commonly used PT ICD-10 codes. 

Code Name

Diagnosis Common Name

Additional Name(s)

Billable?

ICD-10 M25.511

Pain in right shoulder

N/A

Yes

ICD-10 M25.512

Pain in left shoulder

N/A

Yes

ICD-10 M25.551

Pain in right hip

N/A

Yes

ICD-10 M25.552

Pain in left hip

N/A

Yes

ICD-10 M25.561

Pain in right knee

N/A

Yes

ICD-10 M25.562

Pain in left knee

N/A

Yes

ICD-10 M53.3

Sacrococcygeal disorders,
not elsewhere classified

Coccygodynia

Yes

ICD-10 M54.5

Low back pain

Loin pain
Lumbago NOS

Yes

ICD-10 M54.6

Pain in thoracic spine

N/A

Yes

ICD-10 M54.89

Other dorsalgia

N/A

Yes

ICD-10 M54.9

Dorsalgia, unspecified

Backache NOS
Back pain NOS

Yes

ICD-10 M79.601

Pain in right arm

Pain in right upper limb NOS

Yes

ICD-10 M79.602

Pain in left arm

Pain in left upper limb NOS

Yes

ICD-10 M79.604

Pain in right leg

Pain in right lower leg NOS

Yes

ICD-10 M79.605

Pain in left leg

Pain in left lower limb NOS

Yes

ICD-10 M79.641

Pain in right hand

N/A

Yes

ICD-10 M79.642

Pain in left hand

N/A

Yes

ICD-10 M79.671

Pain in right foot

N/A

Yes

ICD-10 M79.672

Pain in left foot

N/A

Yes

ICD-10 S93.0R

Dislocation of right ankle

N/A

Yes

ICD-10 S93.0L

Dislocation of left ankle

N/A

Yes

ICD-10 S93.2R

Rupture of ligaments at right ankle/foot level

N/A

Yes

ICD-10 S93.2L

Rupture of ligaments at left ankle/foot level

N/A

Yes

ICD-10 S93.40R

Sprain and strain of right ankle: part unspecified

N/A

Yes

ICD-10 S93.40L

Sprain and strain of left ankle: part unspecified

N/A

Yes

ICD-10 S93.41R

Sprain and strain of right ankle: deltoid (ligament)

N/A

Yes

ICD-10 S93.41L

Sprain and strain of left ankle: deltoid (ligament)

N/A

Yes

ICD-10 S93.42R

Sprain and strain of right ankle: calcaneofibular (ligament)

N/A

Yes

ICD-10 S93.42L

Sprain and strain of left ankle: calcaneofibular (ligament

N/A

Yes

ICD-10 S93.43R

Sprain and strain of right ankle: tibiofibular (ligament), distal

N/A

Yes

ICD-10 S93.43L

Sprain and strain of left ankle: tibiofibular (ligament), distal

N/A

Yes

Is there a common physical therapy ICD-10 code that we left out? Let us know at support@thesuperbill.com and we’ll do our best to add it!

What are Physical Therapy CPT Codes?

Current Procedural Terminology (CPT) codes are similar to ICD codes in that they both give providers and insurers a uniform language for medical occurrences. However, the difference between CPT and ICD codes is that CPT codes describe medical services rendered. Where an ICD code identifies a diagnosis, a CPT code marks the procedure or prescription issued in response to a diagnosis. 

For instance, suppose you treat a physical therapy patient with low back pain. The ICD-10 code for the low back pain diagnosis would be M54.5. If you administer a hot/cold pack for the pain, the CPT code for that treatment would be 97010. CPT codes are generally numeric (with a few exceptions) as opposed to the alphanumeric system of ICD codes. 

How to Bill Time Units in PT CPT Codes

Note that many of these procedures are performed multiple times per session. To bill correctly, it’s essential that you understand time units and the 8-minute rule. The standard unit of time for the AMA is 15 minutes. That means that for billing purposes, an hour-long session of manual therapy techniques would have four 97140 codes. (Since each code denotes one 15-minute segment of time.)

Procedures marked N/A are considered “non-timed” services and should be billed per service unit. For instance, if you perform an ultrasound, you will mark code 97035 only one time, regardless of how long it takes. 

Common CPT Codes for Physical Therapy

Lists of CPT codes are harder to find for free than ICD codes. Many websites charge you for their cheat sheets and code-finders. SuperBill’s list of PT CPT codes however, is completely free. Access physical therapy CPT codes—from evaluations to therapeutic exercises and massage therapy CPT codes—here at any time. 

Code Name

Diagnosis Common Name

Duration (Min)

Billable?

92507

SLP Treatment; Individual

N/A

Yes

97010

Hot/Cold Packs

N/A

No
(bundle w/ primary service)

97012

Mechanical Traction

N/A

Yes

97014

Electrical Stimulation (Unattended)

N/A

Yes

97016

Vasopneumatic Device

N/A

Yes

97032

Electrical Stimulation (Manual)

15

Yes

97035

Ultrasound/Phonophoresis

N/A

Yes

97110

Therapeutic exercise

15

Yes

97112

Neuromuscular re-education

15

Yes

97113

Aquatic Therapy/Exercise

15

Yes

97116

Gait Training

15

Yes

97124

Massage Therapy

15

Yes

97140

Manual therapy techniques

15

Yes

97150

Group Therapy

N/A

Yes

97161

PT Evaluation: Low Complexity

N/A

Yes

97162

PT Evaluation: Moderate Complexity

N/A

Yes

97162

PT Evaluation: High Complexity

N/A

Yes

97164

PT Re-Evaluation

N/A

Yes

97530

Therapeutic Activities

15

Yes

97535

Self Care/Home Management Training

15

Yes

Further Reading

For more general medical coding advice, check out our post on CPT and ICD-10 Coding Tips. If you’re an out-of-network provider looking for an easier way to explain OON billing, take a look at How to Explain Superbills and OON Reimbursement to Your Clients

As always, SuperBill is here to help you run a smooth and successful practice. Not only that, SuperBill can help you acquire new patients too! Don’t lose patients to the frustrations of claims filing and denials. To learn how to better support your patients, read our post on Getting Started with SuperBill.

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