How To Use CPT Code 21627

CPT code 21627 describes the surgical procedure known as sternal debridement. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 21627?

CPT 21627 is a code used to describe the surgical procedure of sternal debridement. This procedure involves the removal of damaged, diseased, or unhealthy tissue from the sternum, or breastbone, to allow healthy tissue to grow. It is typically performed to promote healing and prevent infection in patients with sternal wounds or defects.

2. Official Description

The official description of CPT code 21627 is: ‘Sternal debridement.’ This code is used when the provider surgically removes damaged, diseased, or unhealthy tissue from the sternum to facilitate the growth of healthy tissue.

3. Procedure

1. The patient is appropriately prepped and anesthetized for the procedure.
2. The provider makes an incision in the skin over the sternum at the area of the defect.
3. The provider dissects down through the tissue to reach the sternum.
4. Using a bone contouring saw and other surgical tools, the provider carefully debrides the sternum, removing any damaged or unhealthy tissue.
5. The area is then irrigated to ensure cleanliness and to remove any debris.
6. The provider checks for bleeding and takes necessary steps to control it.
7. Finally, the incision is closed using appropriate sutures or other closure methods.

4. Qualifying circumstances

CPT 21627 is typically performed on patients with sternal wounds or defects that require the removal of damaged or unhealthy tissue. This procedure may be necessary to promote healing, prevent infection, or address other complications related to the sternum. It is important to note that the use of this code is specific to sternal debridement and should not be used for debridement procedures on other areas of the body.

5. When to use CPT code 21627

CPT code 21627 should be used when a provider performs a surgical debridement of the sternum to remove damaged or unhealthy tissue. It is important to ensure that the procedure is performed specifically on the sternum and not on other areas of the body. If debridement is performed on other areas, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT code 21627, the provider must document the following information:

• Patient’s diagnosis or condition necessitating sternal debridement
• Description of the debridement procedure performed
• Date of the procedure
• Details of the incision, dissection, debridement, irrigation, and closure
• Any complications encountered during the procedure and their management
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 21627, it is important to ensure that the procedure performed meets the criteria for sternal debridement. This code should not be reported for debridement procedures performed on other areas of the body. Additionally, it is important to follow any specific billing guidelines provided by payers or regulatory bodies to ensure accurate and appropriate reimbursement.

8. Historical information

CPT code 21627 was added to the Current Procedural Terminology system on January 1, 1990. It has undergone several changes over the years, including being added to and removed from the Inpatient Only (IPO) list for Medicare. It is important to stay updated on any changes or updates to ensure accurate coding and billing.

9. Examples

1. A patient with a sternal wound following cardiac surgery requires surgical debridement of the sternum to remove necrotic tissue and promote healing.
2. A patient with a sternal defect due to trauma undergoes sternal debridement to remove damaged tissue and prevent infection.
3. A patient with a chronic sternal wound infection requires surgical debridement to remove infected tissue and facilitate healing.
4. A patient with a sternal wound following a sternotomy for a thoracic procedure undergoes sternal debridement to promote healing and prevent complications.
5. A patient with a sternal wound infection following a cardiac procedure requires surgical debridement to remove infected tissue and prevent further complications.
6. A patient with a sternal wound due to radiation therapy undergoes sternal debridement to remove necrotic tissue and promote healing.
7. A patient with a sternal wound following a chest trauma requires surgical debridement to remove damaged tissue and prevent infection.
8. A patient with a sternal wound infection following a cardiac procedure undergoes sternal debridement to remove infected tissue and promote healing.
9. A patient with a chronic sternal wound requires surgical debridement to remove necrotic tissue and facilitate healing.
10. A patient with a sternal defect due to infection undergoes sternal debridement to remove infected tissue and prevent further complications.