Each physical therapy treatment has a code that must be recorded in the patient’s billing information. The set of physical therapy CPT codes is an essential part of billing practices. A code can describe the type and duration of the treatment. This is how the insurance company determines how much to pay the physical therapist. Therefore, a basic understanding of what the physical therapy CPT codes mean and how they are used is necessary for any physical therapist and staff in the clinic who might have billing responsibilities.
CPT codes is an acronym for Current Procedure Terminology codes. The complete list of physical therapy CPT codes is made and maintained by the American Medical Association (AMA). The list is updated annually. Every year, the physical therapist can purchase the book that contains the list of physical therapy CPT codes. It is not recommended to try to keep using the same book for codes rather than buying new books every year since using outdated codes can cause billing errors, nonpayment, and delays in receiving payment for services from insurance companies.
The American Medical Association protects the list from copyright infringement. People are not allowed to publish copies of the list of physical therapy CPT codes. The companies that make and distribute medical billing or office management software buy the rights to use the physical therapy CPT codes in their software programs. Some of these programs allows the physical therapist to enter the codes directly in the patient’s digital record during the treatment session. This helps prevent missing information and errors in the patient’s billing data.
Insurance companies have lists of physical therapy CPT codes of the services that the policies cover. A patient who needs physical therapy treatment may notice these codes when consulting the insurance information to see if a treatment is covered. The patient also can ask the staff at the physical therapy business or call the insurance company for information about insurance coverage for a treatment.
Medical billing is often called medical coding due to the use of codes to indicate the types of services performed and how much the insurance company owes the physical therapist for the services. Physical therapy offices may have software that contains a scrolling list of the physical therapy CPT codes.
Accuracy is very important when adding physical therapy CPT codes to the billing information. The wrong code can lead to mistakes in billing and delays in getting paid for the services that were provided. It is common for all doctors’ offices to have some loss of revenue due to mistakes in billing.