How To Use CPT Code 27054

CPT 27054 describes the procedure of arthrotomy with synovectomy for the hip joint. 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 27054?

CPT 27054 is used to describe the surgical procedure of arthrotomy with synovectomy specifically for the hip joint. This code is utilized when a healthcare provider makes an incision to open the hip joint and removes the inflamed synovial membrane lining the joint. The goal of this procedure is to alleviate pain caused by the inflamed synovium.

2. Official Description

The official description of CPT code 27054 is: ‘Arthrotomy with synovectomy, hip joint.’

3. Procedure

1. The healthcare provider begins by making an incision in the skin just above the hip joint.
2. They then dissect through the subcutaneous tissue to reach the joint capsule.
3. The joint capsule is incised and opened to expose the synovium, which is the membrane lining the joint cavity.
4. The inflamed synovium is carefully removed from the joint.
5. Afterwards, the wound is irrigated with an antibiotic solution to prevent infection.
6. The provider then closes the wound in layers, and if necessary, may leave a drain in place.

4. Qualifying circumstances

CPT 27054 is performed when a patient presents with hip joint pain caused by an inflamed synovium. The procedure is typically indicated when conservative treatments have failed to provide relief. It is important to note that this procedure is specific to the hip joint and should not be used for other joints.

5. When to use CPT code 27054

CPT code 27054 should be used when a healthcare provider performs an arthrotomy with synovectomy specifically for the hip joint. It is important to accurately document the procedure and ensure that it aligns with the official description of CPT 27054.

6. Documentation requirements

To support a claim for CPT 27054, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for arthrotomy with synovectomy
• Specific details of the procedure performed, including the location (hip joint)
• Date of the procedure
• Incision size and location
• Details of the synovectomy, including any complications or additional findings
• Use of any drains or other post-operative measures
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 27054, ensure that the procedure performed aligns with the official description of the code. It is important to accurately document the details of the procedure and provide any necessary supporting documentation. Additionally, be aware of any specific billing guidelines or modifiers that may be required by insurance providers or payers.

8. Historical information

CPT 27054 was added to the Current Procedural Terminology system on January 1, 1990. It was initially categorized as an Inpatient Only (IPO) procedure, but it was later removed from the IPO list in 2021. However, as of 2022, it has been added back to the IPO list.

9. Examples

1. A patient with hip joint pain undergoes arthrotomy with synovectomy to alleviate the symptoms.
2. A healthcare provider performs arthrotomy with synovectomy for a patient with an inflamed synovium in the hip joint.
3. Arthrotomy with synovectomy is performed on a patient with a history of hip joint inflammation.
4. A healthcare provider performs arthrotomy with synovectomy for a patient with chronic hip joint pain.
5. A patient with a diagnosed hip joint synovitis undergoes arthrotomy with synovectomy to improve their condition.
6. Arthrotomy with synovectomy is performed on a patient with limited mobility and hip joint inflammation.
7. A healthcare provider performs arthrotomy with synovectomy for a patient with a known hip joint synovial hypertrophy.
8. A patient with recurrent hip joint effusion undergoes arthrotomy with synovectomy to address the issue.
9. Arthrotomy with synovectomy is performed on a patient with a suspected hip joint infection.
10. A healthcare provider performs arthrotomy with synovectomy for a patient with a history of hip joint trauma and persistent inflammation.