How To Use CPT Code 27066

CPT 27066 describes the excision of a deep bone cyst or benign tumor from specific areas of the pelvis and hip joint, including the wing of the 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 27066?

CPT 27066 is used to describe the excision of a deep bone cyst or benign tumor from specific areas of the pelvis and hip joint. The procedure involves removing the diseased portion of bone, including an appropriate margin of normal bone around the lesion. The provider may also rebuild the excised portion of bone using a graft obtained from the patient’s own body.

2. Official Description

The official description of CPT code 27066 is: ‘Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; deep (subfascial), includes autograft, when performed.’

3. Procedure

1. The provider begins by making an incision in the skin over the targeted area of the pelvis or hip joint.
2. They then dissect deeply through the soft tissue, taking care to preserve the nerves and veins.
3. The periosteum, the outer covering of the bone, is reflected to expose the bone cyst or tumor.
4. The provider removes the diseased portion of bone, ensuring to take an appropriate margin of normal bone around the lesion.
5. If necessary, they may use a cancellous bone graft obtained from other spongy bones near the surgical site to repair the bone defect.
6. Hemostasis is achieved at the surgical site, and the soft tissues are sutured in layers to close the wound.

4. Qualifying circumstances

CPT 27066 is performed on patients with deep bone cysts or benign tumors located in the wing of the ilium, symphysis pubis, or greater trochanter of the femur. The procedure is typically performed by a provider who is experienced in performing excisions of bone cysts or tumors. The use of an autograft, obtained from the patient’s own body, is included in this code when performed.

5. When to use CPT code 27066

CPT code 27066 should be used when a provider performs the excision of a deep bone cyst or benign tumor from the specified areas of the pelvis and hip joint. This code is appropriate when the excision is performed deep below the fascia. If the excision is superficial, CPT code 27065 should be used instead. If the excision requires a separate incision for the autograft, CPT code 27067 should be used.

6. Documentation requirements

To support a claim for CPT code 27066, the provider must document the following information:

• Patient’s diagnosis of a deep bone cyst or benign tumor
• Description of the specific areas of the pelvis or hip joint where the excision was performed
• Details of the procedure, including the incision, dissection, removal of the diseased bone, and use of an autograft if performed
• Any additional procedures or repairs performed during the same surgical session
• Any complications or unexpected findings encountered during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 27066, ensure that the excision is performed deep below the fascia in the specified areas of the pelvis and hip joint. If an autograft is performed, it should be included in the billing. It is important to note that CPT code 27066 should not be reported if CPT codes 27067 or 27068 have already been performed in the previous seven days. Additionally, consider the location of the testing when coding for pulmonary function tests, as they have both a professional and technical component.

8. Historical information

CPT code 27066 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2011, with the addition of the phrase ‘with or without autograft’ to the description.

9. Examples

1. A provider performs the excision of a deep bone cyst from the wing of the ilium in a patient with a history of bone abnormalities.
2. An orthopedic surgeon removes a benign tumor from the greater trochanter of the femur in a patient experiencing hip pain.
3. A patient with a bone cyst in the symphysis pubis undergoes an excision procedure performed by a skilled orthopedic specialist.
4. A provider performs the excision of a deep bone cyst from the wing of the ilium, including an autograft, in a patient with a history of bone abnormalities.
5. An orthopedic surgeon removes a benign tumor from the greater trochanter of the femur, including an autograft, in a patient experiencing hip pain.
6. A patient with a bone cyst in the symphysis pubis undergoes an excision procedure, including an autograft, performed by a skilled orthopedic specialist.
7. A provider performs the excision of a deep bone cyst from the wing of the ilium in a patient with a history of bone abnormalities.