How To Use CPT Code 27065

CPT 27065 describes the excision of a superficial bone cyst or benign tumor from specific areas of the pelvis and hip joint, including the wing of ilium, symphysis pubis, or greater trochanter of the femur. 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 27065?

CPT 27065 is used to describe the excision of a superficial bone cyst or benign tumor from specific areas of the pelvis and hip joint. This procedure involves removing the diseased portion of bone, including an appropriate margin of normal bone around the lesion. The excised portion of bone may be rebuilt using a graft obtained from the patient’s own body.

2. Official Description

The official description of CPT code 27065 is: ‘Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; superficial, includes autograft, when performed.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision in the skin over the targeted area.
3. He dissects down through the soft tissue, preserving the nerves and veins.
4. The periosteum, the outer covering of the bone, is reflected to expose the bone cyst or tumor.
5. The provider excises the diseased portion of bone, taking an appropriate margin of normal bone around the lesion.
6. If necessary, he may rebuild the defect in the bone using a cancellous bone graft obtained from other spongy bones near the surgical site.
7. Hemostasis is achieved at the surgical site, and the wound is closed by suturing the soft tissues in layers.

4. Qualifying circumstances

CPT 27065 is performed when the bone cyst or benign tumor is superficially located in the wing of ilium, symphysis pubis, or greater trochanter of the femur. The procedure may include the use of an autograft, which is a graft obtained from the patient’s own body. It is important to note that this code is specifically for superficial bone cysts or tumors.

5. When to use CPT code 27065

CPT code 27065 should be used when a provider performs the excision of a superficial bone cyst or benign tumor from the specified areas of the pelvis and hip joint. It is important to ensure that the cyst or tumor is superficially located and that the procedure includes an autograft, if performed.

6. Documentation requirements

To support a claim for CPT 27065, the provider must document the following information:

• Patient’s diagnosis and the need for excision of the bone cyst or tumor
• Specific location of the cyst or tumor (wing of ilium, symphysis pubis, or greater trochanter of femur)
• Details of the procedure, including the incision, dissection, excision, and grafting, if performed
• Use of an autograft, if applicable
• Date of the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27065, ensure that the procedure meets the criteria for a superficial bone cyst or benign tumor excision from the specified areas of the pelvis and hip joint. It is important to include the use of an autograft, if performed. Additionally, be aware of other codes that may be appropriate for deep bone cyst or tumor excisions or autografts requiring separate incisions.

8. Historical information

CPT 27065 was added to the Current Procedural Terminology system on January 1, 1990. The code was later revised on January 1, 2011 to include the option of performing the excision with or without an autograft.

9. Examples

1. A provider performs the excision of a superficial bone cyst from the wing of ilium, including an autograft obtained from the patient’s own body.
2. A patient undergoes the excision of a benign tumor from the symphysis pubis, with the use of an autograft for reconstruction.
3. A provider performs the excision of a superficial bone cyst from the greater trochanter of the femur, including an autograft to repair the defect.
4. A superficial bone cyst is excised from the wing of ilium, and an autograft is used to rebuild the excised portion of bone.
5. A benign tumor is excised from the symphysis pubis, and an autograft is utilized for reconstruction.
6. The provider performs the excision of a superficial bone cyst from the greater trochanter of the femur, including an autograft for repair.
7. A patient undergoes the excision of a superficial bone cyst from the wing of ilium, with the use of an autograft to rebuild the excised portion of bone.
8. A benign tumor is excised from the symphysis pubis, and an autograft is utilized for reconstruction.
9. The provider performs the excision of a superficial bone cyst from the greater trochanter of the femur, including an autograft for repair.
10. A superficial bone cyst is excised from the wing of ilium, and an autograft is used to rebuild the excised portion of bone.