CCM · Physical Medicine & Rehab
CCM Qualifying Diagnoses
for Physical Medicine & Rehab.
240 ICD-10-CM codes cover physical medicine & rehab patients for Chronic Care Management (CCM).
Qualifying Codes
ICD-10 codes for physical medicine & rehab.
Neurologic and cognitive
Parkinson's disease and secondary parkinsonism
G20, G21, G23, G24, G2545 codesccmpcmrtmGait, activity and fall detection, with therapy adherence tracked under RTM.
Parkinson's disease and secondary parkinsonism
G20, G21, G23, G24, G2545 codesccmpcmrtmCMS chronic condition · CCW category: Parkinson's Disease and Secondary Parkinsonism · Devices: Contactless activity and fall radar, Patient-reported outcome app (RTM)
G20 alone is no longer valid. Code to G20.A1, G20.A2, G20.B1, G20.B2 or G20.C.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| G20.A1 | Parkinson's disease without dyskinesia, without mention of fluctuations | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G20.A2 | Parkinson's disease without dyskinesia, with fluctuations | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G20.B1 | Parkinson's disease with dyskinesia, without mention of fluctuations | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G20.B2 | Parkinson's disease with dyskinesia, with fluctuations | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G20.C | Parkinsonism, unspecified | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G21.0 | Malignant neuroleptic syndrome | ccmpcmrtm | not risk adjusted |
| G21.11 | Neuroleptic induced parkinsonism | ccmpcmrtm | not risk adjusted |
| G21.19 | Other drug induced secondary parkinsonism | ccmpcmrtm | not risk adjusted |
| G21.2 | Secondary parkinsonism due to other external agents | ccmpcmrtm | not risk adjusted |
| G21.3 | Postencephalitic parkinsonism | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G21.4 | Vascular parkinsonism | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G21.8 | Other secondary parkinsonism | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G21.9 | Secondary parkinsonism, unspecified | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.0 | Hallervorden-Spatz disease | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.1 | Progressive supranuclear ophthalmoplegia [Steele-Richardson-Olszewski] | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.2 | Striatonigral degeneration | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.3 | Hypomyelination with atrophy of the basal ganglia and cerebellum | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.8 | Other specified degenerative diseases of basal ganglia | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.9 | Degenerative disease of basal ganglia, unspecified | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G24.01 | Drug induced subacute dyskinesia | ccmpcmrtm | not risk adjusted |
| G24.02 | Drug induced acute dystonia | ccmpcmrtm | not risk adjusted |
| G24.09 | Other drug induced dystonia | ccmpcmrtm | not risk adjusted |
| G24.1 | Genetic torsion dystonia | ccmpcmrtm | not risk adjusted |
| G24.2 | Idiopathic nonfamilial dystonia | ccmpcmrtm | not risk adjusted |
| G24.3 | Spasmodic torticollis | ccmpcmrtm | not risk adjusted |
| G24.4 | Idiopathic orofacial dystonia | ccmpcmrtm | not risk adjusted |
| G24.5 | Blepharospasm | ccmpcmrtm | not risk adjusted |
| G24.8 | Other dystonia | ccmpcmrtm | not risk adjusted |
| G24.9 | Dystonia, unspecified | ccmpcmrtm | not risk adjusted |
| G25.0 | Essential tremor | ccmpcmrtm | not risk adjusted |
| G25.1 | Drug-induced tremor | ccmpcmrtm | not risk adjusted |
| G25.2 | Other specified forms of tremor | ccmpcmrtm | not risk adjusted |
| G25.3 | Myoclonus | ccmpcmrtm | not risk adjusted |
| G25.4 | Drug-induced chorea | ccmpcmrtm | not risk adjusted |
| G25.5 | Other chorea | ccmpcmrtm | not risk adjusted |
| G25.61 | Drug induced tics | ccmpcmrtm | not risk adjusted |
| G25.69 | Other tics of organic origin | ccmpcmrtm | not risk adjusted |
| G25.70 | Drug induced movement disorder, unspecified | ccmpcmrtm | not risk adjusted |
| G25.71 | Drug induced akathisia | ccmpcmrtm | not risk adjusted |
| G25.79 | Other drug induced movement disorders | ccmpcmrtm | not risk adjusted |
| G25.81 | Restless legs syndrome | ccmpcmrtm | not risk adjusted |
| G25.82 | Stiff-man syndrome | ccmpcmrtm | not risk adjusted |
| G25.83 | Benign shuddering attacks | ccmpcmrtm | not risk adjusted |
| G25.89 | Other specified extrapyramidal and movement disorders | ccmpcmrtm | not risk adjusted |
| G25.9 | Extrapyramidal and movement disorder, unspecified | ccmpcmrtm | not risk adjusted |
Multiple sclerosis and demyelinating disease
G35, G36, G3721 codesccmpcmrtmFunction and fatigue tracking, with therapy adherence under RTM.
Multiple sclerosis and demyelinating disease
G35, G36, G3721 codesccmpcmrtmCMS other chronic or potentially disabling condition · CCW category: Multiple Sclerosis and Transverse Myelitis · Devices: Patient-reported outcome app (RTM), Contactless activity and fall radar
G35 alone is no longer valid as of FY2026. Code to G35.A through G35.D.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| G35.A | Relapsing-remitting multiple sclerosis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.B0 | Primary progressive multiple sclerosis, unspecified | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.B1 | Active primary progressive multiple sclerosis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.B2 | Non-active primary progressive multiple sclerosis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.C0 | Secondary progressive multiple sclerosis, unspecified | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.C1 | Active secondary progressive multiple sclerosis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.C2 | Non-active secondary progressive multiple sclerosis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.D | Multiple sclerosis, unspecified | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G36.0 | Neuromyelitis optica [Devic] | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G36.1 | Acute and subacute hemorrhagic leukoencephalitis [Hurst] | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G36.8 | Other specified acute disseminated demyelination | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G36.9 | Acute disseminated demyelination, unspecified | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.0 | Diffuse sclerosis of central nervous system | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.1 | Central demyelination of corpus callosum | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.2 | Central pontine myelinolysis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.3 | Acute transverse myelitis in demyelinating disease of central nervous system | ccmpcmrtm | HCC 182 · Spinal Cord Disorders/Injuries |
| G37.4 | Subacute necrotizing myelitis of central nervous system | ccmpcmrtm | HCC 182 · Spinal Cord Disorders/Injuries |
| G37.5 | Concentric sclerosis [Balo] of central nervous system | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.81 | Myelin oligodendrocyte glycoprotein antibody disease | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.89 | Other specified demyelinating diseases of central nervous system | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.9 | Demyelinating disease of central nervous system, unspecified | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
Polyneuropathy and nerve disorders
G54, G56, G57, G58, G59, G60, G61, G62, G63, G64, G65107 codes in familyccmpcmrtmPain and function scores, most often alongside diabetes management.
Polyneuropathy and nerve disorders
G54, G56, G57, G58, G59, G60, G61, G62, G63, G64, G65107 codes in familyccmpcmrtmAdded by CCN Health · Devices: Patient-reported outcome app (RTM)
This family runs to 107 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within G54, G56, G57, G58, G59, G60, G61, G62, G63, G64, G65.
Paralysis, cerebral palsy and spinal cord injury
G80, G81, G82, G83, G9562 codes in familyccmpcmrtmFunction, mobility and pressure-injury surveillance.
Paralysis, cerebral palsy and spinal cord injury
G80, G81, G82, G83, G9562 codes in familyccmpcmrtmCMS other chronic or potentially disabling condition · CCW category: Cerebral Palsy · Devices: Contactless activity and fall radar, Patient-reported outcome app (RTM)
This family runs to 62 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within G80, G81, G82, G83, G95.
Traumatic brain injury sequelae
F06, F07, G93.1, G93.424 codes in familyccmbhipcmCognitive and behavioural follow-up with structured instruments.
Traumatic brain injury sequelae
F06, F07, G93.1, G93.424 codes in familyccmbhipcmCMS other chronic or potentially disabling condition · CCW category: Traumatic Brain Injury and Nonpsychotic Mental Disorders due to Brain Damage · Devices: Patient-reported outcome app (RTM)
This family runs to 24 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within F06, F07, G93.1, G93.4.
Muscular dystrophy and myopathies
G71, G72, G7340 codes in familyccmpcmrtmFunction tracking, with respiratory surveillance where the diaphragm is involved.
Muscular dystrophy and myopathies
G71, G72, G7340 codes in familyccmpcmrtmCMS other chronic or potentially disabling condition · CCW category: Muscular Dystrophy · Devices: Patient-reported outcome app (RTM), Pulse oximeter
This family runs to 40 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within G71, G72, G73.
Musculoskeletal and pain
Osteoarthritis
M15, M16, M17, M18, M1998 codesrtmccmPain scores, range of motion and home-exercise adherence. This is the core RTM use case.
Osteoarthritis
M15, M16, M17, M18, M1998 codesrtmccmCMS chronic condition · CCW category: Rheumatoid Arthritis/Osteoarthritis · Devices: Patient-reported outcome app (RTM)
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| M15.0 | Primary generalized (osteo)arthritis | rtmccm | not risk adjusted |
| M15.1 | Heberden's nodes (with arthropathy) | rtmccm | not risk adjusted |
| M15.2 | Bouchard's nodes (with arthropathy) | rtmccm | not risk adjusted |
| M15.3 | Secondary multiple arthritis | rtmccm | not risk adjusted |
| M15.4 | Erosive (osteo)arthritis | rtmccm | not risk adjusted |
| M15.8 | Other polyosteoarthritis | rtmccm | not risk adjusted |
| M15.9 | Polyosteoarthritis, unspecified | rtmccm | not risk adjusted |
| M16.0 | Bilateral primary osteoarthritis of hip | rtmccm | not risk adjusted |
| M16.10 | Unilateral primary osteoarthritis, unspecified hip | rtmccm | not risk adjusted |
| M16.11 | Unilateral primary osteoarthritis, right hip | rtmccm | not risk adjusted |
| M16.12 | Unilateral primary osteoarthritis, left hip | rtmccm | not risk adjusted |
| M16.2 | Bilateral osteoarthritis resulting from hip dysplasia | rtmccm | not risk adjusted |
| M16.30 | Unilateral osteoarthritis resulting from hip dysplasia, unspecified hip | rtmccm | not risk adjusted |
| M16.31 | Unilateral osteoarthritis resulting from hip dysplasia, right hip | rtmccm | not risk adjusted |
| M16.32 | Unilateral osteoarthritis resulting from hip dysplasia, left hip | rtmccm | not risk adjusted |
| M16.4 | Bilateral post-traumatic osteoarthritis of hip | rtmccm | not risk adjusted |
| M16.50 | Unilateral post-traumatic osteoarthritis, unspecified hip | rtmccm | not risk adjusted |
| M16.51 | Unilateral post-traumatic osteoarthritis, right hip | rtmccm | not risk adjusted |
| M16.52 | Unilateral post-traumatic osteoarthritis, left hip | rtmccm | not risk adjusted |
| M16.6 | Other bilateral secondary osteoarthritis of hip | rtmccm | not risk adjusted |
| M16.7 | Other unilateral secondary osteoarthritis of hip | rtmccm | not risk adjusted |
| M16.9 | Osteoarthritis of hip, unspecified | rtmccm | not risk adjusted |
| M17.0 | Bilateral primary osteoarthritis of knee | rtmccm | not risk adjusted |
| M17.10 | Unilateral primary osteoarthritis, unspecified knee | rtmccm | not risk adjusted |
| M17.11 | Unilateral primary osteoarthritis, right knee | rtmccm | not risk adjusted |
| M17.12 | Unilateral primary osteoarthritis, left knee | rtmccm | not risk adjusted |
| M17.2 | Bilateral post-traumatic osteoarthritis of knee | rtmccm | not risk adjusted |
| M17.30 | Unilateral post-traumatic osteoarthritis, unspecified knee | rtmccm | not risk adjusted |
| M17.31 | Unilateral post-traumatic osteoarthritis, right knee | rtmccm | not risk adjusted |
| M17.32 | Unilateral post-traumatic osteoarthritis, left knee | rtmccm | not risk adjusted |
| M17.4 | Other bilateral secondary osteoarthritis of knee | rtmccm | not risk adjusted |
| M17.5 | Other unilateral secondary osteoarthritis of knee | rtmccm | not risk adjusted |
| M17.9 | Osteoarthritis of knee, unspecified | rtmccm | not risk adjusted |
| M18.0 | Bilateral primary osteoarthritis of first carpometacarpal joints | rtmccm | not risk adjusted |
| M18.10 | Unilateral primary osteoarthritis of first carpometacarpal joint, unspecified hand | rtmccm | not risk adjusted |
| M18.11 | Unilateral primary osteoarthritis of first carpometacarpal joint, right hand | rtmccm | not risk adjusted |
| M18.12 | Unilateral primary osteoarthritis of first carpometacarpal joint, left hand | rtmccm | not risk adjusted |
| M18.2 | Bilateral post-traumatic osteoarthritis of first carpometacarpal joints | rtmccm | not risk adjusted |
| M18.30 | Unilateral post-traumatic osteoarthritis of first carpometacarpal joint, unspecified hand | rtmccm | not risk adjusted |
| M18.31 | Unilateral post-traumatic osteoarthritis of first carpometacarpal joint, right hand | rtmccm | not risk adjusted |
| M18.32 | Unilateral post-traumatic osteoarthritis of first carpometacarpal joint, left hand | rtmccm | not risk adjusted |
| M18.4 | Other bilateral secondary osteoarthritis of first carpometacarpal joints | rtmccm | not risk adjusted |
| M18.50 | Other unilateral secondary osteoarthritis of first carpometacarpal joint, unspecified hand | rtmccm | not risk adjusted |
| M18.51 | Other unilateral secondary osteoarthritis of first carpometacarpal joint, right hand | rtmccm | not risk adjusted |
| M18.52 | Other unilateral secondary osteoarthritis of first carpometacarpal joint, left hand | rtmccm | not risk adjusted |
| M18.9 | Osteoarthritis of first carpometacarpal joint, unspecified | rtmccm | not risk adjusted |
| M19.011 | Primary osteoarthritis, right shoulder | rtmccm | not risk adjusted |
| M19.012 | Primary osteoarthritis, left shoulder | rtmccm | not risk adjusted |
| M19.019 | Primary osteoarthritis, unspecified shoulder | rtmccm | not risk adjusted |
| M19.021 | Primary osteoarthritis, right elbow | rtmccm | not risk adjusted |
| M19.022 | Primary osteoarthritis, left elbow | rtmccm | not risk adjusted |
| M19.029 | Primary osteoarthritis, unspecified elbow | rtmccm | not risk adjusted |
| M19.031 | Primary osteoarthritis, right wrist | rtmccm | not risk adjusted |
| M19.032 | Primary osteoarthritis, left wrist | rtmccm | not risk adjusted |
| M19.039 | Primary osteoarthritis, unspecified wrist | rtmccm | not risk adjusted |
| M19.041 | Primary osteoarthritis, right hand | rtmccm | not risk adjusted |
| M19.042 | Primary osteoarthritis, left hand | rtmccm | not risk adjusted |
| M19.049 | Primary osteoarthritis, unspecified hand | rtmccm | not risk adjusted |
| M19.071 | Primary osteoarthritis, right ankle and foot | rtmccm | not risk adjusted |
| M19.072 | Primary osteoarthritis, left ankle and foot | rtmccm | not risk adjusted |
| M19.079 | Primary osteoarthritis, unspecified ankle and foot | rtmccm | not risk adjusted |
| M19.09 | Primary osteoarthritis, other specified site | rtmccm | not risk adjusted |
| M19.111 | Post-traumatic osteoarthritis, right shoulder | rtmccm | not risk adjusted |
| M19.112 | Post-traumatic osteoarthritis, left shoulder | rtmccm | not risk adjusted |
| M19.119 | Post-traumatic osteoarthritis, unspecified shoulder | rtmccm | not risk adjusted |
| M19.121 | Post-traumatic osteoarthritis, right elbow | rtmccm | not risk adjusted |
| M19.122 | Post-traumatic osteoarthritis, left elbow | rtmccm | not risk adjusted |
| M19.129 | Post-traumatic osteoarthritis, unspecified elbow | rtmccm | not risk adjusted |
| M19.131 | Post-traumatic osteoarthritis, right wrist | rtmccm | not risk adjusted |
| M19.132 | Post-traumatic osteoarthritis, left wrist | rtmccm | not risk adjusted |
| M19.139 | Post-traumatic osteoarthritis, unspecified wrist | rtmccm | not risk adjusted |
| M19.141 | Post-traumatic osteoarthritis, right hand | rtmccm | not risk adjusted |
| M19.142 | Post-traumatic osteoarthritis, left hand | rtmccm | not risk adjusted |
| M19.149 | Post-traumatic osteoarthritis, unspecified hand | rtmccm | not risk adjusted |
| M19.171 | Post-traumatic osteoarthritis, right ankle and foot | rtmccm | not risk adjusted |
| M19.172 | Post-traumatic osteoarthritis, left ankle and foot | rtmccm | not risk adjusted |
| M19.179 | Post-traumatic osteoarthritis, unspecified ankle and foot | rtmccm | not risk adjusted |
| M19.19 | Post-traumatic osteoarthritis, other specified site | rtmccm | not risk adjusted |
| M19.211 | Secondary osteoarthritis, right shoulder | rtmccm | not risk adjusted |
| M19.212 | Secondary osteoarthritis, left shoulder | rtmccm | not risk adjusted |
| M19.219 | Secondary osteoarthritis, unspecified shoulder | rtmccm | not risk adjusted |
| M19.221 | Secondary osteoarthritis, right elbow | rtmccm | not risk adjusted |
| M19.222 | Secondary osteoarthritis, left elbow | rtmccm | not risk adjusted |
| M19.229 | Secondary osteoarthritis, unspecified elbow | rtmccm | not risk adjusted |
| M19.231 | Secondary osteoarthritis, right wrist | rtmccm | not risk adjusted |
| M19.232 | Secondary osteoarthritis, left wrist | rtmccm | not risk adjusted |
| M19.239 | Secondary osteoarthritis, unspecified wrist | rtmccm | not risk adjusted |
| M19.241 | Secondary osteoarthritis, right hand | rtmccm | not risk adjusted |
| M19.242 | Secondary osteoarthritis, left hand | rtmccm | not risk adjusted |
| M19.249 | Secondary osteoarthritis, unspecified hand | rtmccm | not risk adjusted |
| M19.271 | Secondary osteoarthritis, right ankle and foot | rtmccm | not risk adjusted |
| M19.272 | Secondary osteoarthritis, left ankle and foot | rtmccm | not risk adjusted |
| M19.279 | Secondary osteoarthritis, unspecified ankle and foot | rtmccm | not risk adjusted |
| M19.29 | Secondary osteoarthritis, other specified site | rtmccm | not risk adjusted |
| M19.90 | Unspecified osteoarthritis, unspecified site | rtmccm | not risk adjusted |
| M19.91 | Primary osteoarthritis, unspecified site | rtmccm | not risk adjusted |
| M19.92 | Post-traumatic osteoarthritis, unspecified site | rtmccm | not risk adjusted |
| M19.93 | Secondary osteoarthritis, unspecified site | rtmccm | not risk adjusted |
Rheumatoid and inflammatory arthritis
M05, M06, M08, M12, M13, M45, M46743 codes in familyrtmccmpcmDisease-activity scores, function and therapy adherence.
Rheumatoid and inflammatory arthritis
M05, M06, M08, M12, M13, M45, M46743 codes in familyrtmccmpcmCMS chronic condition · CCW category: Rheumatoid Arthritis/Osteoarthritis · Devices: Patient-reported outcome app (RTM)
This family runs to 743 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within M05, M06, M08, M12, M13, M45, M46.
Low back pain and dorsalgia
M54, M51.1, M51.3, M47.81, M43.166 codesrtmccmPain, function and home-exercise adherence, the standard RTM programme.
Low back pain and dorsalgia
M54, M51.1, M51.3, M47.81, M43.166 codesrtmccmAdded by CCN Health · Devices: Patient-reported outcome app (RTM)
M54.5 was deleted on 2021-10-01. Code to M54.50, M54.51 (vertebrogenic) or M54.59.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| M43.10 | Spondylolisthesis, site unspecified | rtmccm | not risk adjusted |
| M43.11 | Spondylolisthesis, occipito-atlanto-axial region | rtmccm | not risk adjusted |
| M43.12 | Spondylolisthesis, cervical region | rtmccm | not risk adjusted |
| M43.13 | Spondylolisthesis, cervicothoracic region | rtmccm | not risk adjusted |
| M43.14 | Spondylolisthesis, thoracic region | rtmccm | not risk adjusted |
| M43.15 | Spondylolisthesis, thoracolumbar region | rtmccm | not risk adjusted |
| M43.16 | Spondylolisthesis, lumbar region | rtmccm | not risk adjusted |
| M43.17 | Spondylolisthesis, lumbosacral region | rtmccm | not risk adjusted |
| M43.18 | Spondylolisthesis, sacral and sacrococcygeal region | rtmccm | not risk adjusted |
| M43.19 | Spondylolisthesis, multiple sites in spine | rtmccm | not risk adjusted |
| M47.811 | Spondylosis without myelopathy or radiculopathy, occipito-atlanto-axial region | rtmccm | not risk adjusted |
| M47.812 | Spondylosis without myelopathy or radiculopathy, cervical region | rtmccm | not risk adjusted |
| M47.813 | Spondylosis without myelopathy or radiculopathy, cervicothoracic region | rtmccm | not risk adjusted |
| M47.814 | Spondylosis without myelopathy or radiculopathy, thoracic region | rtmccm | not risk adjusted |
| M47.815 | Spondylosis without myelopathy or radiculopathy, thoracolumbar region | rtmccm | not risk adjusted |
| M47.816 | Spondylosis without myelopathy or radiculopathy, lumbar region | rtmccm | not risk adjusted |
| M47.817 | Spondylosis without myelopathy or radiculopathy, lumbosacral region | rtmccm | not risk adjusted |
| M47.818 | Spondylosis without myelopathy or radiculopathy, sacral and sacrococcygeal region | rtmccm | not risk adjusted |
| M47.819 | Spondylosis without myelopathy or radiculopathy, site unspecified | rtmccm | not risk adjusted |
| M51.14 | Intervertebral disc disorders with radiculopathy, thoracic region | rtmccm | not risk adjusted |
| M51.15 | Intervertebral disc disorders with radiculopathy, thoracolumbar region | rtmccm | not risk adjusted |
| M51.16 | Intervertebral disc disorders with radiculopathy, lumbar region | rtmccm | not risk adjusted |
| M51.17 | Intervertebral disc disorders with radiculopathy, lumbosacral region | rtmccm | not risk adjusted |
| M51.34 | Other intervertebral disc degeneration, thoracic region | rtmccm | not risk adjusted |
| M51.35 | Other intervertebral disc degeneration, thoracolumbar region | rtmccm | not risk adjusted |
| M51.360 | Other intervertebral disc degeneration, lumbar region with discogenic back pain only | rtmccm | not risk adjusted |
| M51.361 | Other intervertebral disc degeneration, lumbar region with lower extremity pain only | rtmccm | not risk adjusted |
| M51.362 | Other intervertebral disc degeneration, lumbar region with discogenic back pain and lower extremity pain | rtmccm | not risk adjusted |
| M51.369 | Other intervertebral disc degeneration, lumbar region without mention of lumbar back pain or lower extremity pain | rtmccm | not risk adjusted |
| M51.370 | Other intervertebral disc degeneration, lumbosacral region with discogenic back pain only | rtmccm | not risk adjusted |
| M51.371 | Other intervertebral disc degeneration, lumbosacral region with lower extremity pain only | rtmccm | not risk adjusted |
| M51.372 | Other intervertebral disc degeneration, lumbosacral region with discogenic back pain and lower extremity pain | rtmccm | not risk adjusted |
| M51.379 | Other intervertebral disc degeneration, lumbosacral region without mention of lumbar back pain or lower extremity pain | rtmccm | not risk adjusted |
| M54.00 | Panniculitis affecting regions of neck and back, site unspecified | rtmccm | not risk adjusted |
| M54.01 | Panniculitis affecting regions of neck and back, occipito-atlanto-axial region | rtmccm | not risk adjusted |
| M54.02 | Panniculitis affecting regions of neck and back, cervical region | rtmccm | not risk adjusted |
| M54.03 | Panniculitis affecting regions of neck and back, cervicothoracic region | rtmccm | not risk adjusted |
| M54.04 | Panniculitis affecting regions of neck and back, thoracic region | rtmccm | not risk adjusted |
| M54.05 | Panniculitis affecting regions of neck and back, thoracolumbar region | rtmccm | not risk adjusted |
| M54.06 | Panniculitis affecting regions of neck and back, lumbar region | rtmccm | not risk adjusted |
| M54.07 | Panniculitis affecting regions of neck and back, lumbosacral region | rtmccm | not risk adjusted |
| M54.08 | Panniculitis affecting regions of neck and back, sacral and sacrococcygeal region | rtmccm | not risk adjusted |
| M54.09 | Panniculitis affecting regions, neck and back, multiple sites in spine | rtmccm | not risk adjusted |
| M54.10 | Radiculopathy, site unspecified | rtmccm | not risk adjusted |
| M54.11 | Radiculopathy, occipito-atlanto-axial region | rtmccm | not risk adjusted |
| M54.12 | Radiculopathy, cervical region | rtmccm | not risk adjusted |
| M54.13 | Radiculopathy, cervicothoracic region | rtmccm | not risk adjusted |
| M54.14 | Radiculopathy, thoracic region | rtmccm | not risk adjusted |
| M54.15 | Radiculopathy, thoracolumbar region | rtmccm | not risk adjusted |
| M54.16 | Radiculopathy, lumbar region | rtmccm | not risk adjusted |
| M54.17 | Radiculopathy, lumbosacral region | rtmccm | not risk adjusted |
| M54.18 | Radiculopathy, sacral and sacrococcygeal region | rtmccm | not risk adjusted |
| M54.2 | Cervicalgia | rtmccm | not risk adjusted |
| M54.30 | Sciatica, unspecified side | rtmccm | not risk adjusted |
| M54.31 | Sciatica, right side | rtmccm | not risk adjusted |
| M54.32 | Sciatica, left side | rtmccm | not risk adjusted |
| M54.40 | Lumbago with sciatica, unspecified side | rtmccm | not risk adjusted |
| M54.41 | Lumbago with sciatica, right side | rtmccm | not risk adjusted |
| M54.42 | Lumbago with sciatica, left side | rtmccm | not risk adjusted |
| M54.50 | Low back pain, unspecified | rtmccm | not risk adjusted |
| M54.51 | Vertebrogenic low back pain | rtmccm | not risk adjusted |
| M54.59 | Other low back pain | rtmccm | not risk adjusted |
| M54.6 | Pain in thoracic spine | rtmccm | not risk adjusted |
| M54.81 | Occipital neuralgia | rtmccm | not risk adjusted |
| M54.89 | Other dorsalgia | rtmccm | not risk adjusted |
| M54.9 | Dorsalgia, unspecified | rtmccm | not risk adjusted |
Chronic pain and fibromyalgia
M79.7, G89.2, G89.4, R52, G93.310 codesrtmccmbhiPain scores, sleep and function, with behavioural support where indicated.
Chronic pain and fibromyalgia
M79.7, G89.2, G89.4, R52, G93.310 codesrtmccmbhiCMS other chronic or potentially disabling condition · CCW category: Fibromyalgia, Chronic Pain and Fatigue · Devices: Patient-reported outcome app (RTM)
G89.4 (chronic pain syndrome) and G89.29 (other chronic pain) are secondary codes. Code the underlying condition alongside.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| G89.21 | Chronic pain due to trauma | rtmccmbhi | not risk adjusted |
| G89.22 | Chronic post-thoracotomy pain | rtmccmbhi | not risk adjusted |
| G89.28 | Other chronic postprocedural pain | rtmccmbhi | not risk adjusted |
| G89.29 | Other chronic pain | rtmccmbhi | not risk adjusted |
| G89.4 | Chronic pain syndrome | rtmccmbhi | not risk adjusted |
| G93.31 | Postviral fatigue syndrome | rtmccmbhi | not risk adjusted |
| G93.32 | Myalgic encephalomyelitis/chronic fatigue syndrome | rtmccmbhi | not risk adjusted |
| G93.39 | Other post infection and related fatigue syndromes | rtmccmbhi | not risk adjusted |
| M79.7 | Fibromyalgia | rtmccmbhi | not risk adjusted |
| R52 | Pain, unspecified | rtmccmbhi | not risk adjusted |
Mobility impairment and acquired deformity
M20, M21, M24, M25, R26, Z74.0, Z99.3596 codes in familyrtmccmGait, activity level and fall events.
Mobility impairment and acquired deformity
M20, M21, M24, M25, R26, Z74.0, Z99.3596 codes in familyrtmccmCMS other chronic or potentially disabling condition · CCW category: Mobility Impairments · Devices: Contactless activity and fall radar, Patient-reported outcome app (RTM)
This family runs to 596 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within M20, M21, M24, M25, R26, Z74.0, Z99.3.
Other chronic and potentially disabling
Pressure ulcers and chronic ulcers
L89, L97, L98.4407 codes in familyccmpcmrtmRepositioning and mobility surveillance alongside structured wound assessment.
Pressure ulcers and chronic ulcers
L89, L97, L98.4407 codes in familyccmpcmrtmCMS other chronic or potentially disabling condition · CCW category: Pressure Ulcers and Chronic Ulcers · Devices: Contactless activity and fall radar
This family runs to 407 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within L89, L97, L98.4.
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Clinical Context
Why physical medicine & rehab practices benefit from CCM.
Physical Medicine & Rehab practices can leverage CCM to improve patient outcomes through structured care management, generating $97–$220+ per patient per month in Medicare reimbursement while reducing avoidable hospitalizations.
FAQ
Common questions.
What ICD-10 codes qualify physical medicine & rehab patients for CCM?
CMS publishes no list of codes that qualify a patient for CCM: eligibility turns on the condition and on documented medical necessity. For physical medicine & rehab, 240 billable ICD-10-CM codes cover the conditions CCM manages, spanning 12 conditions including parkinson's disease and secondary parkinsonism, multiple sclerosis and demyelinating disease, polyneuropathy and nerve disorders, paralysis, cerebral palsy and spinal cord injury, traumatic brain injury sequelae, muscular dystrophy and myopathies.
How does CCN Health support physical medicine & rehab practices with CCM?
CCN Health provides turnkey CCM services for physical medicine & rehab practices, including patient eligibility identification, enrollment documentation, device provisioning, clinical monitoring, and full Medicare billing support.
What is the revenue potential for CCM in physical medicine & rehab?
Reimbursement varies by locality and payer contract, so see the CCM billing guide for current figures. Physical Medicine & Rehab practices with a high prevalence of these conditions generally see the most benefit, particularly when CCM is combined with RPM and BHI for patients whose needs are distinct enough to document separately.
Sources & Compliance
Code set. Every code on this page is drawn from the official ICD-10-CM ICD-10-CM FY2026 (valid 2025-10-01 through 2026-09-30) released by CDC/NCHS, and only codes flagged valid for submission are listed. ICD-10-CM is published by the federal government and is in the public domain, so the descriptions here are the official long descriptors reproduced verbatim rather than summarized. The next code set, ICD-10-CM FY2027 (valid from 2026-10-01), is already reflected in the change flags.
Eligibility is not a code list. CMS does not publish a list of ICD-10 codes that qualify a patient for RPM, CCM, PCM, BHI, or RTM. Eligibility turns on the condition and on documented medical necessity. The programs shown against each condition are CCN Health’s clinical assessment of which programs that condition can support, not a statement of CMS approval.
Risk adjustment. HCC labels and category assignments come from the CMS-HCC V28 model for the 2026 payment year. Risk adjustment depends on the full encounter record, not on a single code, and the flags here are a prompt to check specificity rather than a payment guarantee.
CPT® notice. CPT is a registered trademark of the American Medical Association. CPT codes, descriptions, and other data only are copyright 2026 American Medical Association. All rights reserved. CPT is provided “as is” without warranty of any kind.
Sources. ICD-10-CM files, CDC/NCHS (cdc.gov); CMS Chronic Conditions Data Warehouse condition categories (ccwdata.org); CMS-HCC risk adjustment model software and ICD-10 mappings (cms.gov); AHRQ Clinical Classifications Software Refined (ahrq.gov).
Disclaimer. This page is informational and does not constitute billing, clinical, or legal advice. Diagnosis coding must reflect the documentation in the medical record. Verify all codes against the official CMS and CDC/NCHS publications and your contracted payer agreements before billing.