How To Use CPT Code 27105

CPT 27105 describes the transfer of a paraspinal muscle to the hip joint using a fascial or tendon graft. 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 27105?

CPT 27105 can be used to describe the transfer of a paraspinal muscle to the hip joint, utilizing a graft made from fascia or tendon. This procedure is performed to compensate for the loss of function in another muscle. The provider makes an incision over the paraspinal muscle, detaches it from its attachment, and passes it to the desired location on the hip joint. A graft is obtained from muscles such as the peroneus or fascia lata to ensure sufficient muscle length. The paraspinal muscle is then fixed in place over the hip joint. The goal is to restore function and improve the patient’s mobility.

2. Official Description

The official description of CPT code 27105 is: ‘Transfer paraspinal muscle to hip (includes fascial or tendon extension graft).’ This code encompasses the transfer of a paraspinal muscle to the hip joint, along with the use of a fascial or tendon graft to extend the muscle.

3. Procedure

1. The provider makes an incision over the paraspinal muscle to be transferred.
2. The paraspinal muscle is detached from its attachment.
3. A graft is obtained from muscles like the peroneus or fascia lata.
4. The graft is attached to the muscle being transferred to ensure sufficient length.
5. The paraspinal muscle is fixed in place over the hip joint.
6. Hemostasis is achieved at the surgical site, and the wound is closed by suturing the soft tissue in layers.

4. Qualifying circumstances

CPT 27105 is performed when there is a need to transfer a paraspinal muscle to the hip joint to compensate for the loss of function in another muscle. This procedure is typically indicated when other conservative treatments have failed to provide adequate relief or improvement. The patient must be appropriately prepped and anesthetized for the procedure. The provider must ensure that the patient is a suitable candidate for the transfer and that the benefits outweigh the potential risks.

5. When to use CPT code 27105

CPT code 27105 should be used when a paraspinal muscle is transferred to the hip joint using a fascial or tendon graft. This code is appropriate when the procedure is performed to restore function and improve mobility in patients with a loss of muscle function in the hip joint. It is important to accurately document the medical necessity and rationale for performing this procedure.

6. Documentation requirements

To support a claim for CPT code 27105, the provider must document the following information:

• The patient’s diagnosis and the need for the paraspinal muscle transfer
• The specific paraspinal muscle being transferred
• The type of graft used (fascial or tendon)
• The date of the procedure
• A detailed description of the procedure performed
• Any complications or unexpected findings
• Post-operative instructions and follow-up plans

7. Billing guidelines

When billing for CPT code 27105, ensure that the procedure meets the criteria outlined in the official description. It is important to accurately document the medical necessity and rationale for performing this procedure. Additionally, follow any specific billing guidelines provided by the payer or insurance company. It is crucial to use the appropriate CPT code based on the specific procedure performed and to avoid unbundling or duplicating charges.

8. Historical information

CPT code 27105 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with a history of hip joint dysfunction undergoes a paraspinal muscle transfer to the hip joint using a fascial graft to restore function and improve mobility.
2. A provider performs a paraspinal muscle transfer to the hip joint with a tendon graft for a patient with a loss of muscle function due to a previous injury.
3. In a case of congenital hip dysplasia, a paraspinal muscle is transferred to the hip joint using a fascial graft to improve stability and function.
4. A patient with hip joint degeneration undergoes a paraspinal muscle transfer with a tendon graft to alleviate pain and improve range of motion.
5. A provider performs a paraspinal muscle transfer to the hip joint using a fascial graft for a patient with muscle weakness and instability in the hip joint.
6. In a case of hip joint trauma, a paraspinal muscle is transferred to the hip joint with a tendon graft to restore function and stability.
7. A patient with a history of failed conservative treatments for hip joint dysfunction undergoes a paraspinal muscle transfer using a fascial graft to improve mobility and quality of life.
8. A provider performs a paraspinal muscle transfer to the hip joint with a tendon graft for a patient with muscle atrophy and weakness in the hip joint.
9. In a case of hip joint avascular necrosis, a paraspinal muscle is transferred to the hip joint using a fascial graft to restore blood supply and improve function.
10. A patient with hip joint instability due to ligament laxity undergoes a paraspinal muscle transfer with a tendon graft to enhance joint stability and prevent further damage.