How To Use CPT Code 27120

CPT 27120 describes a surgical procedure known as acetabuloplasty, which involves modifying the shape of the acetabulum, the cup-shaped socket of the hip joint. This article will provide an overview of CPT code 27120, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 27120?

CPT 27120 is a code used to describe acetabuloplasty, a surgical procedure that aims to correct congenital dislocation of the hip or treat hip osteoarthritis. During this procedure, the provider surgically modifies the shape of the acetabulum, which is the cup-shaped socket of the hip joint. The goal is to improve the alignment and function of the hip joint, thereby alleviating pain and improving mobility for the patient.

2. Official Description

The official description of CPT code 27120 is: ‘Acetabuloplasty; (eg, Whitman, Colonna, Haygroves, or cup type).’ This code specifically refers to the surgical procedure of modifying the shape of the acetabulum using various techniques, such as those mentioned in the description.

3. Procedure

1. When performing acetabuloplasty, the provider begins by making an incision in the skin, extending from the front of the iliac area to the outer side of the thigh.
2. Next, the provider carefully dissects through the soft tissue, ensuring the protection of nerves and blood vessels.
3. The muscles are then retracted to expose the joint capsule, which is incised to enter the joint.
4. Once inside the joint, the provider exposes the outer and inner surfaces of the ilium, marking the level and extent of the osteotomy to be performed.
5. An osteotomy is initiated, involving the cutting of the bone cortex on the inner and outer side of the ilium.
6. After completing the osteotomy, the provider uses an osteotome to move the mobile acetabulum, achieving the desired correction in its shape.
7. A cancellous bone graft is obtained from the iliac crest and used to fill the osteotomy site in the ilium.
8. Hemostasis is achieved at the surgical site, and the wound is closed by suturing the soft tissue layers.
9. Finally, the patient is placed in a hip cast for a period of four to six weeks to support proper healing.

4. Qualifying circumstances

Acetabuloplasty is typically performed on patients with congenital dislocation of the hip or hip osteoarthritis. These conditions cause significant pain and functional limitations, warranting surgical intervention to improve the alignment and function of the hip joint. The procedure is performed by a qualified healthcare provider with expertise in orthopedic surgery.

5. When to use CPT code 27120

CPT code 27120 should be used when the provider performs acetabuloplasty to modify the shape of the acetabulum. It is important to ensure that the procedure meets the specific criteria outlined in the code description. This code should not be used for other hip joint procedures or surgeries that do not involve acetabuloplasty.

6. Documentation requirements

When reporting CPT code 27120, the provider must document the following information:

• Patient’s diagnosis, indicating the need for acetabuloplasty
• Description of the specific technique used (e.g., Whitman, Colonna, Haygroves, or cup type)
• Date of the procedure
• Details of the surgical approach and steps performed during the procedure
• Any additional procedures or interventions performed during the same surgical session
• Postoperative care instructions and follow-up plans
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 27120, it is important to ensure that the procedure performed aligns with the specific requirements outlined in the code description. Acetabuloplasty should not be reported with other hip joint procedures unless they are distinct and separately identifiable. It is crucial to review payer-specific guidelines and documentation requirements to ensure accurate and appropriate billing for this procedure.

8. Historical information

CPT code 27120 was added to the Current Procedural Terminology system on January 1, 1990. Over the years, there have been changes in its status, including being added and removed from the Inpatient Only (IPO) list for Medicare. It is important to stay updated with the latest coding guidelines and payer policies regarding the use of CPT code 27120.

9. Examples

1. A patient with congenital dislocation of the hip undergoes acetabuloplasty to correct the alignment of the acetabulum and improve hip joint function.
2. An individual with hip osteoarthritis undergoes acetabuloplasty to alleviate pain and improve mobility.
3. A provider performs acetabuloplasty using the Whitman technique to address a patient’s congenital hip dislocation.
4. Acetabuloplasty is performed on a patient with hip osteoarthritis using the Colonna technique.
5. A provider performs acetabuloplasty using the Haygroves technique to correct the shape of the acetabulum in a patient with congenital dislocation of the hip.
6. An individual with hip osteoarthritis undergoes acetabuloplasty using a cup-type technique to improve joint function.
7. A provider performs acetabuloplasty on a patient with congenital dislocation of the hip, utilizing a combination of techniques to achieve the desired correction.