PT Billing Reference 2026

ICD-10 codes for physical therapy

Search a curated PT-focused subset of official April 2026 ICD-10-CM descriptions, with neutral documentation reminders.

Common PT ICD-10 codes by category

Lumbar & Spinal

M54.50

Low back pain, unspecified

Confirm whether the record supports a more specific low-back-pain code.

M54.41

Lumbago with sciatica, right side

Confirm right-sided symptoms and supporting examination findings.

M54.42

Lumbago with sciatica, left side

Confirm left-sided symptoms and supporting examination findings.

M47.816

Spondylosis without myelopathy or radiculopathy, lumbar region

Use the official description; this code does not indicate radiculopathy.

M51.16

Intervertebral disc disorders with radiculopathy, lumbar region

Confirm the documented lumbar radiculopathy and applicable encounter details.

Shoulder

M75.00

Adhesive capsulitis of unspecified shoulder

Confirm laterality and document the mobility restrictions supporting the diagnosis.

M75.50

Bursitis of unspecified shoulder

Use a laterality-specific code when supported by the record.

M75.20

Bicipital tendinitis, unspecified shoulder

Confirm the diagnosis and laterality before selecting a code.

Knee

M17.11

Unilateral primary osteoarthritis, right knee

Confirm right-knee laterality and the supporting clinical record.

M23.200

Derangement of unspecified lateral meniscus due to old tear or injury, right knee

This title specifies an old lateral-meniscus tear or injury of the right knee.

Z96.651

Presence of right artificial knee joint

Use as context when the record confirms a right artificial knee joint.

Neurological

G81.90

Hemiplegia, unspecified affecting unspecified side

Use a more specific dominance and laterality code when the record supports it.

G82.20

Paraplegia, unspecified

Confirm whether a more specific neurologic code is supported.

G11.9

Hereditary ataxia, unspecified

Confirm the documented diagnosis and related functional findings.

G12.21

Amyotrophic lateral sclerosis

Confirm the documented diagnosis and related functional findings.

Functional Limitation Codes

Z74.09

Other reduced mobility

Use only when the documented mobility limitation and coding context support it.

Z96.641

Presence of right artificial hip joint

Use as context when the record confirms a right artificial hip joint.

R26.81

Unsteadiness on feet

Confirm the documented gait or balance findings supporting this code.

M62.81

Muscle weakness (generalized)

Document the specific muscle groups, measurements, and functional effects.

Reference only — based on a PT-focused subset of CMS descriptions effective April 1 through September 30, 2026. Always verify current codes and payer guidance.

ICD-10 documentation tips for PT

Match the code to the record

Use laterality, encounter details, and specificity only when they are supported by the referral and clinical documentation.

A code does not establish medical necessity by itself

Document the examination findings, functional limitations, plan, and skilled need required by your organization and payer.

Use secondary codes intentionally

Secondary codes may add relevant context, but they should not replace an accurate primary diagnosis or payer-specific guidance.

Verify the current code set

ICD-10-CM changes over time. Confirm the code, title, billable status, and payer rules before submitting a claim.

Live public reference

Use the searchable PT ICD-10 reference above.

Verify every final code with current official, organizational, and payer guidance.