CPT & ICD-10 Codes
When billing insurance, you need two types of codes: CPT codes to describe what you did, and ICD-10 codes to describe why you did it. Understanding these codes is essential for accurate claims and timely reimbursement.
CPT Codes (Procedure Codes)
CPT (Current Procedural Terminology) codes describe the services you performed. Common examples for wellness practitioners:
- 97140 -- Manual therapy techniques
- 97110 -- Therapeutic exercises
- 97530 -- Therapeutic activities
- 97112 -- Neuromuscular re-education
- 90837 -- Psychotherapy, 60 minutes
Each CPT code has a standard rate that you set based on your fee schedule.
ICD-10 Codes (Diagnosis Codes)
ICD-10 codes describe the client's condition or reason for treatment. These justify the medical necessity of the services provided. Examples:
- M54.5 -- Low back pain
- M25.511 -- Pain in right shoulder
- G43.909 -- Migraine, unspecified
Using Codes in Stillpoint
- When creating a claim, search for codes by number or description
- Link each CPT code to one or more ICD-10 diagnosis codes
- Stillpoint stores your recently used codes for quick access
Tips
- Always verify that your diagnosis codes support the procedures being billed
- Stay current with annual code updates, as codes can change each year
- Use the most specific code available rather than a general or unspecified code
- Consult your payer's guidelines for covered procedure codes and documentation requirements