Physical Therapy Billing

Physical therapy is an important component of healthcare that helps people recover from injuries, illnesses, and surgeries by improving their mobility, strength, and flexibility. Physical therapy medical billing involves the process of submitting and processing claims for reimbursement of the services provided by physical therapists. In this article, we will discuss the important codes used in physical therapy medical billing.

CPT Codes: Current Procedural Terminology (CPT) codes are used to describe medical procedures and services provided by healthcare providers. For physical therapy, the following CPT codes are commonly used:

• 97110: Therapeutic exercises to improve strength, range of motion, and flexibility
• 97112: Neuromuscular reeducation to improve balance, coordination, and posture
• 97116: Gait training to improve walking and mobility
• 97140: Manual therapy techniques, such as massage or joint mobilization, to relieve pain and improve function
• 97530: Therapeutic activities, such as games or puzzles, to improve cognitive and motor skills

ICD-10 Codes: International Classification of Diseases, 10th Revision (ICD-10) codes are used to describe medical diagnoses and conditions. For physical therapy, the following ICD-10 codes are commonly used:

• M25.50: Pain in the joint, not elsewhere classified
• M54.5: Low back pain
• M62.81: Muscle weakness (generalized)
• M75.52: Rotator cuff tear or rupture
• M79.2: Neuralgia and neuritis, unspecified
• M87.0: Osteonecrosis due to drugs
• M87.1: Osteonecrosis due to previous trauma
• S83.511A: Sprain of anterior cruciate ligament of right knee, initial encounter

Modifiers: Modifiers are used to provide additional information about the services provided by physical therapists. The following modifiers are commonly used in physical therapy medical billing:

• GP: Services provided by a physical therapist
• GO: Services provided by an occupational therapist
• KX: Services that exceed Medicare's cap on therapy services
• 59: Distinct procedural service, used to indicate a service that is separate and distinct from other services provided on the same day

In addition to these codes and modifiers, physical therapy medical billing may also involve other important components, such as insurance verification, prior authorization, and documentation requirements. It is important for physical therapists and their billing staff to stay up-to-date on the latest codes and regulations to ensure accurate and timely reimbursement for the services provided.

Physical therapy medical billing involves the use of CPT and ICD-10 codes, as well as modifiers, to describe the services provided by physical therapists and the conditions being treated. These codes are essential for submitting claims and receiving reimbursement from insurance providers. Physical therapists and their billing staff should be well-versed in these codes and other billing requirements to ensure smooth and efficient billing processes.

?Legion Healthcare Solutions is a leading medical billing company providing complete billing and coding services. We can help you in receiving timely and accurate reimbursements for your physical therapy services. To know more about our physical therapy billing services, contact us at 727-475-1834 or email us at [email protected]