How To Use CPT Code 27003

CPT 27003 describes the surgical procedure of tenotomy and obturator neurectomy for the adductor muscle of the hip. 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 27003?

CPT 27003 can be used to describe the surgical procedure in which a provider performs an open tenotomy of the adductor muscle of the hip, along with the removal of the obturator nerve. This code is used when the provider divides the muscle tendon to correct a deformity caused by congenital or acquired shortening of the muscle.

2. Official Description

The official description of CPT code 27003 is: ‘Tenotomy, adductor, subcutaneous, open, with obturator neurectomy.’ The notes for this code state that if the procedure is performed bilaterally, modifier 50 should be appended to the code.

3. Procedure

1. In this procedure, the provider makes an incision in the skin extending from the pubis along the inner thigh over the adductor muscle.
2. After dissecting through the subcutaneous tissue, the provider gains adequate exposure of the adductor muscle to be divided.
3. The provider identifies the anterior and posterior branches of the obturator nerve in between the muscles and removes the nerve.
4. Next, the provider incises the tendon to lengthen it, allowing the muscle to return to its normal length and correcting the deformity.
5. Hemostasis is obtained at the surgical site, and the wound is closed by suturing the soft tissue in layers.
6. A cast is applied to keep the hip in abduction for three to four weeks to ensure proper healing.

4. Qualifying circumstances

CPT 27003 is performed most commonly in patients with cerebral palsy who have a hypertonic adductor muscle that restricts the abduction motion of the hip. It is used to correct the deformity caused by the shortening of the muscle. The procedure is performed by a provider who is appropriately trained and qualified to perform tenotomy and obturator neurectomy.

5. When to use CPT code 27003

CPT code 27003 should be used when the provider performs an open tenotomy of the adductor muscle of the hip, along with the removal of the obturator nerve. It is appropriate to use this code when correcting a deformity caused by the shortening of the muscle. If the procedure is performed bilaterally, modifier 50 should be appended to the code.

6. Documentation requirements

To support a claim for CPT 27003, the provider must document the following information:

• Patient’s diagnosis and the need for the tenotomy and obturator neurectomy
• Details of the procedure, including the incision, dissection, identification and removal of the obturator nerve, and incision of the tendon
• Length of the procedure
• Any complications or unexpected findings
• Post-operative care instructions
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27003, ensure that the procedure is performed by a qualified provider and that the documentation supports the medical necessity of the procedure. If the procedure is performed bilaterally, modifier 50 should be appended to the code. It is important to follow the specific guidelines provided by the payer to ensure accurate and appropriate billing.

8. Historical information

CPT 27003 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A provider performs an open tenotomy of the adductor muscle of the hip, along with the removal of the obturator nerve, to correct a deformity caused by cerebral palsy in a patient.
2. In a patient with acquired shortening of the adductor muscle, a provider performs an open tenotomy and obturator neurectomy to restore normal muscle length and correct the deformity.
3. A provider performs a bilateral open tenotomy and obturator neurectomy in a patient with congenital shortening of the adductor muscle.
4. In a patient with hypertonicity of the adductor muscle due to cerebral palsy, a provider performs an open tenotomy and obturator neurectomy to improve the range of motion in the hip joint.
5. A provider performs an open tenotomy and obturator neurectomy in a patient with a deformity caused by acquired shortening of the adductor muscle, allowing for improved mobility and function.
6. In a patient with a hypertonic adductor muscle, a provider performs an open tenotomy and obturator neurectomy to correct the deformity and improve the patient’s quality of life.
7. A provider performs an open tenotomy and obturator neurectomy in a patient with cerebral palsy, allowing for increased range of motion and improved ambulation.
8. In a patient with a congenital deformity of the hip, a provider performs an open tenotomy and obturator neurectomy to correct the alignment and improve function.
9. A provider performs an open tenotomy and obturator neurectomy in a patient with acquired shortening of the adductor muscle, resulting in improved mobility and reduced pain.
10. In a patient with hypertonicity of the adductor muscle, a provider performs an open tenotomy and obturator neurectomy to alleviate the restriction of hip abduction and improve overall function.