How To Use CPT Code 27132

CPT 27132 refers to the conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 27132 procedures.

1. What is CPT 27132?

CPT 27132 is a medical procedure code used to describe the conversion of a previous hip surgery to total hip arthroplasty, with or without the use of autograft or allograft. This code is utilized when a patient with hip arthritis, who has previously undergone hip surgery other than total hip arthroplasty, requires a total hip replacement to relieve pain and improve function.

2. 27132 CPT code description

The official description of CPT code 27132 is: “Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft.”

3. Procedure

The 27132 procedure involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider enters the hip joint, typically by opening the previous hip surgery incision.
3. Dissection through the subcutaneous tissue to reach the hip joint capsule is performed.
4. The sciatic nerve is identified and protected, and the soft tissue is released.
5. Any implant from the previous hip surgery is removed.
6. The hip joint is manually dislocated, and the femoral component is separated from the acetabulum.
7. The femoral head is removed from the end of the femur using a saw.
8. A reamer is used in the acetabulum to create a hemispherical bone socket for the acetabular prosthesis.
9. The acetabular prosthetic component is placed in the socket and secured with bone cement and, possibly, a graft.
10. The femoral shaft canal is prepared using a reamer or rasp for inserting the femoral prosthetic component.
11. The femoral prosthetic stem is inserted into the femoral shaft and affixed with bone cement.
12. The two components are reunited using a graft, if appropriate, and cement, and the hip joint is reduced, restoring normal alignment.
13. The wound is irrigated with antibiotic solution and closed in layers, with a drain possibly left in place if required.

4. Qualifying circumstances

Patients eligible to receive CPT code 27132 services are those with hip arthritis who have previously undergone hip surgery other than total hip arthroplasty and have not responded to more conservative treatment options. The goal of this procedure is to relieve pain and improve function in these patients.

5. When to use CPT code 27132

It is appropriate to bill the 27132 CPT code when a provider performs a conversion of a previous hip surgery to total hip arthroplasty, with or without autograft or allograft. This code should be used when the patient has a history of hip surgery other than total hip arthroplasty and requires a total hip replacement due to unresponsive hip arthritis.

6. Documentation requirements

To support a claim for CPT 27132, the following information should be documented:

• Patient’s medical history, including previous hip surgery and conservative treatment attempts
• Physical examination findings, including hip joint pain and limited range of motion
• Diagnostic imaging results, such as X-rays or MRI, confirming hip arthritis
• Indication for the procedure, including the rationale for converting the previous hip surgery to total hip arthroplasty
• Detailed description of the procedure, including the use of autograft or allograft if applicable
• Postoperative care plan and follow-up instructions

7. Billing guidelines

When billing for CPT code 27132, it is essential to ensure that the patient’s medical record contains the necessary documentation to support the claim. Additionally, be aware of any payer-specific guidelines or requirements related to billing for this code. It is also crucial to differentiate CPT 27132 from similar codes, such as 27130, 27134, 27137, and 27138, which describe different types of hip arthroplasty procedures.

8. Historical information

CPT 27132 was added to the Current Procedural Terminology system in 1990. The code’s descriptor was changed on January 1, 2002, from “Conversion of previous hip surgery to total hip replacement, with or without autograft or allograft” to its current description. In 2017, the code was added to the Medicare Inpatient Only (IPO) list, removed in 2021, and added back to the IPO list in 2022.

9. Similar codes to CPT 27132

Five similar codes to CPT 27132 and how they differentiate are:

• CPT 27130: Total hip arthroplasty, not a conversion of a previous hip surgery.
• CPT 27134: Revision arthroplasty of the hip, replacing both femoral and acetabular components.
• CPT 27137: Revision arthroplasty of the hip, replacing only the acetabular component, with or without autograft or allograft.
• CPT 27138: Revision arthroplasty of the hip, replacing only the femoral component, with or without autograft or allograft.
• CPT 27125: Hemiarthroplasty, hip, partial (e.g., femoral stem prosthesis, bipolar arthroplasty).

10. Examples

Here are 10 detailed examples of CPT code 27132 procedures:

1. A patient with a history of hip fracture surgery now requires total hip arthroplasty due to severe hip arthritis.
2. A patient who previously underwent hip resurfacing surgery experiences worsening pain and limited mobility, necessitating conversion to total hip arthroplasty.
3. A patient with a history of hip osteotomy surgery develops hip arthritis and requires total hip arthroplasty for pain relief and improved function.
4. A patient who had a previous hip arthrodesis now requires conversion to total hip arthroplasty due to persistent pain and limited mobility.
5. A patient with a history of hip joint debridement surgery experiences worsening hip arthritis and requires conversion to total hip arthroplasty.
6. A patient who previously underwent hip joint distraction surgery develops severe hip arthritis and requires conversion to total hip arthroplasty.
7. A patient with a history of hip joint synovectomy surgery experiences progressive hip arthritis and requires conversion to total hip arthroplasty for pain relief.
8. A patient who had a previous hip joint fusion surgery develops worsening hip arthritis and requires conversion to total hip arthroplasty for improved function.
9. A patient with a history of hip joint reconstruction surgery experiences persistent pain and limited mobility, necessitating conversion to total hip arthroplasty.
10. A patient who previously underwent hip joint replacement surgery with a partial prosthesis now requires conversion to total hip arthroplasty due to severe hip arthritis.