Medical billing for physical therapy involves coding and billing practices specific to the services provided by physical therapists. Physical therapy aims to help patients recover from injuries or conditions affecting their musculoskeletal system and improve their overall mobility and function.
Physical therapy billing is intense and challenging as it comes with multiple reasons that lead to claim denials. The most significant reason for claim denials in physical therapy is the “medical necessity” of the service offered. Apart from this, hiring an in-house biller can be very expensive, and it requires a lot of time and effort.
Our team consists of certified, trained coders and billers with a great degree of familiarity with Physical Therapy Billing. They understand the nuances of physical therapy billing and offer strategic solutions to improve the revenue and reduce your practice’s denial rate.
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.
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 improve function and
- 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 is used to describe medical diagnoses and conditions. For physical therapy, the following ICD-10 codes are commonly used:
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
Suneli Billing 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.
- M25.50: Pain in the joint, not elsewhere classified
- M54.50: Low back pain
- M62.81: Muscle weakness (generalized)
- M75.52: Rotator cuff tear or rupture
- M79.2: Neuralgia and neuritis, unspecified
- M87.00: Osteonecrosis due to drugs
- M87.10: Osteonecrosis due to previous trauma
- S83.511A: Sprain of anterior cruciate ligament of right knee, initial encounter
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