How To Use CPT Code 27792

CPT 27792 refers to the open treatment of a distal fibular fracture, including internal fixation when performed. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 27792 procedures.

1. What is CPT 27792?

CPT 27792 is a medical code used to describe the open treatment of a distal fibular fracture, which is a break in the end of the fibula bone of the leg. This code includes internal fixation when performed, which involves securing the fracture with plates, screws, wires, or pins. Medical coders and billers use this code to accurately document and bill for this specific procedure.

2. 27792 CPT code description

The official description of CPT code 27792 is: “Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed.”

3. Procedure

The 27792 CPT code procedure involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider incises the skin overlying the lateral malleolus fracture or a fracture in the distal fibula.
3. The fracture site is identified and explored.
4. The fracture fragments are placed together in the correct anatomical position.
5. The fragments are fixed with plates, screws, wires, or pins, if internal fixation is performed.
6. Hemostasis, or the stoppage of bleeding, is achieved.
7. The area is irrigated and the wound is closed.
8. A long leg cast, brace, or splint is applied to aid in healing.
9. Post-treatment X-rays may be taken to ensure correct alignment.

4. Qualifying circumstances

Patients eligible to receive CPT code 27792 services are those who have sustained a distal fibular fracture and require open treatment, including internal fixation when performed. This code is applicable when the fracture is in the end of the fibula bone of the leg and the provider determines that open treatment is necessary for proper healing and alignment.

5. When to use CPT code 27792

It is appropriate to bill the 27792 CPT code when a patient has a distal fibular fracture that requires open treatment, including internal fixation when performed. This code should be used when the provider has determined that the fracture needs to be treated with an open procedure and internal fixation is necessary for proper healing and alignment.

6. Documentation requirements

To support a claim for CPT 27792, the following information should be documented:

• Patient’s medical history and physical examination findings
• Diagnosis of distal fibular fracture
• Indication for open treatment and internal fixation, if performed
• Description of the procedure, including incision, exploration, reduction, fixation, and wound closure
• Postoperative care instructions and follow-up plan
• Any complications or additional procedures performed during the treatment

7. Billing guidelines

When billing for CPT code 27792, it is important to follow the appropriate guidelines and rules. Ensure that the documentation supports the use of this code and that all necessary information is included in the patient’s medical record. Additionally, be aware of any specific payer requirements or policies related to the billing of this code.

8. Historical information

CPT 27792 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2008, with the previous descriptor being “Open treatment of distal fibular fracture (lateral malleolus), with or without internal or external fixation.”

9. Similar codes to CPT 27792

Five similar codes to CPT 27792 and how they differentiate are:

• CPT 27786: This code is for closed treatment of a distal fibular fracture, without manipulation.
• CPT 27788: This code is for closed treatment of a distal fibular fracture, with manipulation.
• CPT 27750: This code is for treatment of a tibia shaft fracture, without manipulation.
• CPT 27752: This code is for treatment of a tibia shaft fracture, with manipulation.
• CPT 27756: This code is for open treatment of a tibia shaft fracture, with or without internal or external fixation.

10. Examples

Here are 10 detailed examples of CPT code 27792 procedures:

1. A patient with a distal fibular fracture due to a sports injury undergoes open treatment with internal fixation using plates and screws.
2. A patient with a distal fibular fracture from a fall receives open treatment with internal fixation using wires.
3. A patient with a distal fibular fracture caused by a motor vehicle accident undergoes open treatment with internal fixation using pins.
4. A patient with a distal fibular fracture due to a skiing accident receives open treatment with internal fixation using a combination of plates, screws, and wires.
5. A patient with a distal fibular fracture from a bicycle accident undergoes open treatment with internal fixation using a combination of plates and pins.
6. A patient with a distal fibular fracture due to a slip and fall accident receives open treatment with internal fixation using screws and wires.
7. A patient with a distal fibular fracture caused by a workplace injury undergoes open treatment with internal fixation using plates, screws, and pins.
8. A patient with a distal fibular fracture from a hiking accident receives open treatment with internal fixation using a combination of wires and pins.
9. A patient with a distal fibular fracture due to a horseback riding accident undergoes open treatment with internal fixation using plates, screws, wires, and pins.
10. A patient with a distal fibular fracture caused by a motorcycle accident receives open treatment with internal fixation using a combination of plates, screws, wires, and pins.