Physical Therapy Billing Codes Explained

Physical therapy billing codes is a crucial factor in the reimbursement process. Correct usage of the physical therapy billing codes is the key in ensuring that insurance claims will be approved. The proper coding of the patient’s evaluation and diagnosis is a requisite in all insurance claims. Physical therapy coding means translating the notes of the physical therapists into the appropriate codes for the processing by the insurance companies.

Physical therapy billing codes are used not only for billing purposed but can also be used as a source whereby patients can learn more about the examination conducted by the physical therapists, the findings, what services have been provided and to find out the cost of the visit.

Physical therapy billing codes is part of the Healthcare Common Procedure Coding Systems or commonly terms as “hick picks” for the acronym HCPCS. The HIPAA  is the regulating body for HCPCS codes and all healthcare organizations are required to use the standard codes n all transactions which involve health information.

There are two levels of HCPCS codes. Level  I is composed of the CPT codes. Physical therapy CPT codes like those of other medical services identify the services provides and procedures prescribed by the clinician. Level II HCPCS codes identify non-clinician services like ambulance services.

Modifiers might also be needed for proper physical therapy billing codes. Modifiers are consists of two digit numbers, two letter or alphanumeric characters. They provide more information about the services and treatment provided.

There are HCPCS guidelines for the physical therapy billing codes for each insurance carrier especially when it involves Medicare and Medicare claims. Medicare and Medicare have more exacting guidelines.

As a private practice owner, make sure that your staff especially the one in charge of physical therapy billing codes is abreast with the current HCPCS codes. HCPCS codes are updated periodically, some are new, some might be revised or discarded.

The importance of the accuracy of the physical therapy billing codes cannot be over emphasized. It is crucial in the overall profitability of the physical therapy business since reimbursement is a major financial resource. Accuracy will also protect the physical therapists from malpractice suits. After all, there are resources available to patients so they can check if the correct physical therapy billing codes have been applied to the services that were provided to them during the visit.  More specifically, the patients can check the physical therapy CPT codes to find out more details about their problems, the treatment and how all these relate to billing.

Physical therapy billing codes are not only for the benefit of the private practitioner but the patients as well.


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