To help organize diagnoses and treatments in physical therapy the profession has been assigned a series of unique codes. Physical therapists use these codes to create a unified standard for billing. Clinics and their patients in different locations can count on the standard if they change clinics or physicians. There are some key distinctions to be aware of to understand the meaning and application of billing codes.
CPT vs. ICD-10
Two types of billing codes are International Classification of Diseases (ICD-10) codes and Current Procedural Terminology (CPT) codes. ICD-10s identify the diagnosis and CPTs describe the treatment. CPT codes are five digits and are set by the American Medical Association, making them a national standard. The ICD-10’s are overseen by the World Health Organization, giving them international relevance.
Why Code CPTs?
By creating a standard definition or procedure and assigning it a unique code, CPTs can be used by multiple parties involved in the physical therapy process. Patients and clinics need to know the treatments, but so do insurers and accreditation organizations. The CPT code allows all parties involved to refer to the same information associated with the code instead of maintaining their own definitions.
Billing services divide CPT codes into two key types: timed and untimed. Timed CPT codes reflect treatments that are billed based on how long they take. Each code will have a base unit of treatment duration, such as 15 minutes. A 60-minute treatment would then have four units of coding billed to it. Untimed CPT codes apply to treatments that are billed no more than once per day. These distinctions can be used to avoid having patients billed more often than they should when they receive extended therapy or multiple treatments.
Modified CPT Codes
There is a collection of modifier codes that can be used to add clarification to the treatment information represented by CPT codes. Modifiers can be used to confirm that a repeated CPT code is the same treatment given twice and not an accidental duplicate. Modifiers can also indicate if the treatment itself has changed, such as with reduced duration. Using billing services can help make sure you bill for the right procedures and duration based on treatment.
Common CPT Codes
CPTs include codes for things other than the actual treatment, such as modalities and evaluations, because these services are also billed. These are some of the most commonly used: Ultrasound, mechanical traction, and electrical stimulation. For hands on, one-on-one treatment the physical therapists use thes common code types: Therapeutic Exercise, Manual Therapy and Neuromuscular Education.
Physical Therapy Billing Services and CPT
As diagnoses, treatments, and procedures evolve, CPT changes with them. CPT codes are reviewed and updated to accommodate new developments. The frequency of updates makes it helpful for clinics to collaborate with a dedicated physical therapy billing service who stays current on the most recent code sets. Visit PhysicalTherapyBilling.com to learn more about keeping your clinic’s coding up to date.