How To Use CPT Code 26992

CPT 26992 describes the incision of the bone cortex in the pelvis and/or hip joint to treat infections or abscesses. 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 26992?

CPT 26992 can be used to describe the incision of the bone cortex in the pelvis and/or hip joint to treat infections or abscesses. This code is used when the healthcare provider makes an incision in the skin over the infected bone, removes the infected portion, and closes the wound.

2. Official Description

The official description of CPT code 26992 is: ‘Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or bone abscess).’ This procedure involves making an incision in the bone cortex to remove infected or abscessed portions of the bone in the pelvis and/or hip joint.

3. Procedure

  1. The healthcare provider prepares the patient for the procedure and administers anesthesia.
  2. An incision is made in the skin over the infected bone, providing access to the affected area.
  3. The provider incises and reflects the periosteum, the outer membrane of the bone.
  4. The infected or abscessed portion of the bone is debrided or scraped away.
  5. The area is washed with an antibiotic solution to prevent further infection.
  6. The periosteum is placed back in its original position over the bone.
  7. The wound is closed by suturing the soft tissue in layers.

4. Qualifying circumstances

CPT 26992 is performed when there is an infection or abscess in the bone of the pelvis and/or hip joint. The procedure is typically done to remove the infected or abscessed portion of the bone and promote healing. It is important to note that this procedure should only be performed by a qualified healthcare provider.

5. When to use CPT code 26992

CPT code 26992 should be used when the healthcare provider performs an incision of the bone cortex in the pelvis and/or hip joint to treat infections or abscesses. It is important to ensure that the procedure is medically necessary and appropriate for the patient’s condition.

6. Documentation requirements

To support a claim for CPT 26992, the healthcare provider must document the following information:

  • Patient’s diagnosis and the need for the procedure
  • Details of the incision, including the location and size
  • Description of the infected or abscessed portion of the bone
  • Steps taken to remove the infected or abscessed portion
  • Use of anesthesia and any complications
  • Post-procedure care instructions
  • Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 26992, ensure that the procedure is performed by a qualified healthcare provider. It is important to follow the specific guidelines set by the payer and provide accurate documentation to support the claim. It is also important to review any additional guidelines or modifiers that may be required for proper billing.

8. Historical information

CPT 26992 was added to the Current Procedural Terminology system on January 1, 1990. It was initially removed from the Inpatient Only (IPO) list in 2017 but was later added back in 2022. It is important to stay updated on any changes or revisions to the code.

9. Examples

  1. A healthcare provider performs an incision of the bone cortex in the pelvis to remove an abscessed portion of the bone.
  2. An orthopedic surgeon makes an incision in the hip joint to treat osteomyelitis in the bone.
  3. A patient with a bone abscess in the pelvis undergoes a procedure in which the infected portion of the bone is removed through an incision.
  4. A healthcare provider performs an incision of the bone cortex in the hip joint to treat an infection.
  5. An orthopedic surgeon removes an infected portion of the bone in the pelvis through an incision in the bone cortex.
  6. A patient with osteomyelitis in the hip joint undergoes a procedure in which the infected bone is incised and removed.
  7. A healthcare provider performs an incision of the bone cortex in the pelvis to treat a bone abscess.
  8. An orthopedic surgeon makes an incision in the hip joint to remove an infected portion of the bone.
  9. A patient with an abscessed bone in the pelvis undergoes a procedure in which the infected portion is removed through an incision.
  10. A healthcare provider performs an incision of the bone cortex in the hip joint to treat osteomyelitis.

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