How To Use CPT Code 27027

CPT 27027 describes the procedure of decompression fasciotomy for the pelvic (buttock) compartment. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 27027?

CPT 27027 is used to report the decompression fasciotomy procedure for the pelvic (buttock) compartment. This procedure involves making an incision into the fascia surrounding the pelvic compartment to relieve pressure and improve blood flow. It is typically performed on one side of the buttock.

2. Official Description

The official description of CPT code 27027 is: ‘Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle), unilateral.’ This code should be reported with modifier 50 to indicate a bilateral procedure if performed on both sides.

3. Procedure

1. The provider begins by making an incision in the skin overlying the affected area of the pelvic compartment.
2. They then access the fascia above the affected muscle compartment.
3. The provider carefully incises the fascia, reducing the pressure on the neurovascular structures beneath it and restoring blood flow.
4. If necessary, the provider may leave the incision open for drainage or close it by suturing the soft tissues in layers.

4. Qualifying circumstances

CPT 27027 is used for patients with compartment syndrome, a condition characterized by increased pressure within a muscle compartment, leading to muscle and nerve damage and reduced blood flow. The procedure is performed on the pelvic (buttock) compartment, which includes muscles such as the gluteus medius-minimus, gluteus maximus, iliopsoas, and tensor fascia lata. The procedure is typically performed unilaterally, but if performed bilaterally, modifier 50 should be appended to the code.

5. When to use CPT code 27027

CPT code 27027 should be used when the provider performs a decompression fasciotomy on the pelvic (buttock) compartment unilaterally. It is important to ensure that the procedure is medically necessary and meets the criteria for compartment syndrome in the pelvic region.

6. Documentation requirements

To support a claim for CPT 27027, the provider must document the following information:

• Patient’s diagnosis of compartment syndrome
• Specific muscles and compartments involved
• Date of the procedure
• Details of the incision and fasciotomy performed
• Any additional procedures or debridement performed
• Method of wound closure, if applicable

7. Billing guidelines

When billing for CPT 27027, ensure that the procedure is performed unilaterally on the pelvic (buttock) compartment. If the procedure is performed bilaterally, append modifier 50 to indicate a bilateral procedure. It is important to follow the specific guidelines provided by the payer and accurately document the procedure to support the claim.

8. Historical information

CPT 27027 was added to the Current Procedural Terminology system on January 1, 2009. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient presents with compartment syndrome in the pelvic compartment, and the provider performs a decompression fasciotomy on one side of the buttock.
2. Following a traumatic injury, a patient develops compartment syndrome in the pelvic compartment, and the provider performs a decompression fasciotomy to relieve pressure and restore blood flow.
3. A patient with a history of compartment syndrome in the pelvic compartment experiences a recurrence, and the provider performs a decompression fasciotomy on one side of the buttock.
4. During a surgical procedure, a patient develops compartment syndrome in the pelvic compartment, and the provider performs a decompression fasciotomy to prevent further damage.
5. A patient with a chronic condition experiences worsening symptoms of compartment syndrome in the pelvic compartment, and the provider performs a decompression fasciotomy to alleviate the pressure and improve blood flow.