Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesComposite MeasuresCPT cpt-0005f-osteoarthritis-assessment-documentation-tracking
    Ask Trek AI about this page

    CPT 0005F: Osteoarthritis Assessment Documentation

    CPT code 0005F is a supplemental tracking code indicating documentation of an osteoarthritis assessment using specific components; it captures that a clinician completed the required elements of the assessment as a clinical tracking/service documentation activity typically performed in outpatient clinic or office visit settings to record disease-specific evaluation components for quality measurement and clinical records.

    For related coverage guidance, see recent payer policy updates: Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood Pressure, Cardiology - Ivabradine, Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA).

    Customize your policy alerts

    Sign up for cpt 0005F policy alerts

    Get alerted when payer policies referencing 0005F are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 7

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with symptomatic osteoarthritis presenting to an outpatient orthopedic clinic or primary care practice for assessment of disease severity and functional impact. The clinician documents a focused osteoarthritis assessment using specific components such as joint-specific pain location, duration and pattern of symptoms, physical examination findings (range of motion, crepitus, joint deformity, swelling), functional limitations (activities of daily living, gait disturbance), and any relevant imaging review. The workflow commonly includes history taking, directed musculoskeletal examination, review of prior radiographs or MRI if available, documentation of symptom severity and functional status, and recording of assessment elements required for quality tracking. This supplemental tracking code is used in ambulatory settings where documentation meets the specific component requirements for osteoarthritis assessment; typical sites of service include outpatient office clinics, orthopedic specialty clinics, and community health centers. Common payor interactions include submission to commercial plans such as Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare for quality tracking and supplemental reporting of structured osteoarthritis assessment documentation.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesCommon E/M visit during which the osteoarthritis assessment components are documented; supports medical decision-making.
    20610Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder, hip, knee)Performed when joint aspiration or intra-articular injection is indicated after assessment.
    73030Radiologic exam, ankle; complete, minimum of 3 views (example musculoskeletal imaging)Plain radiographs of the affected joint are commonly reviewed and documented as part of OA assessment.
    97110Therapeutic exercises to develop strength and endurance, range of motion and flexibilityPhysical therapy interventions often follow assessment and are documented in the care plan.
    99417Prolonged office or other outpatient E/M service beyond the total time of the primary serviceUsed when additional documentation time is required to meet the detailed component requirements of the osteoarthritis assessment.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    57CPT® modifier -57 (“Decision for Surgery”) is appended to an Evaluation and Management (E/M) service when that encounter results in the initial decision to perform a major surgery (a procedure with a…- Use modifier 57 when an E/M service provided by the same provider (or same tax ID) on the day of or the day before a major surgical procedure (90‑day global period) results in the initial decision…
    27Modifier 27 indicates a separate, subsequent outpatient hospital E/M service provided to the same patient on the same date by a different provider in a hospital outpatient setting. It is a…- Use modifier -27 on facility (hospital outpatient/ambulatory service center) claims to report a subsequent, separate, and distinct outpatient E/M service provided to the same patient on the same…
    73Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but the…
    97Modifier 97 is an informational modifier used with therapy CPT codes to indicate services are rehabilitative — intended to restore skills or function lost due to illness, injury, or disability. It is…- Use modifier 97 when reporting therapy services that are rehabilitative in nature — i.e., provided to restore skills or function lost or impaired because of illness, injury, or disability (for…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207X00000X
    208800000X
    207R00000X
    207K00000X
    363L00000X
    207ZB0001X
    364S00000X
    163WN1003X

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    M12.50Traumatic arthropathy, unspecified site
    M15.0Primary generalized (osteo)arthritis
    M16.11Unilateral primary osteoarthritis, right hip
    M16.12Unilateral primary osteoarthritis, left hip
    M17.0Bilateral primary osteoarthritis of knee
    M17.11Unilateral primary osteoarthritis, right knee
    M17.12Unilateral primary osteoarthritis, left knee
    M17.5Other unilateral secondary osteoarthritis of knee
    M19.011Primary osteoarthritis, right shoulder
    M19.012Primary osteoarthritis, left shoulder

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Cardiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood PressureBluecross Idaho2026-11-01
    Cardiology - IvabradineCigna2026-10-15
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Percutaneous Ventricular Assist DeviceUnitedHealthcare2026-10-01
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Left Atrial Appendage Closure Devicesexcellus_health_plan_inc2026-09-17
    Left Atrial Appendage Closure Devicesuniverahealthcare2026-09-17
    Cardiac Omnibus CodesCigna2026-09-15

    Related Codes

    CPT-0001F-HEART-FAILURE-ASSESSMENT-TRACKING

    CPT 0001F: Heart Failure Assessment, Supplemental Tracking

    CPT-0012F-COMMUNITY-ACQUIRED-BACTERIAL-PNEUMONIA-ASSESSMENT

    CPT 0012F: Community-Acquired Bacterial Pneumonia Assessment

    CPT-0014F-PERFORMANCE-MEASURE-DOCUMENTATION

    CPT 0014F: Unspecified Service or Performance Measure

    CPT-0015F-CLINICAL-SERVICE

    CPT 0015F: Anesthesia Safety Check Documentation

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.