How To Use CPT Code 27122

CPT 27122 describes a surgical procedure known as acetabuloplasty with femoral head resection, also referred to as the Girdlestone procedure. This article will provide an overview of CPT code 27122, 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 27122?

CPT 27122 is a code used to describe a surgical procedure called acetabuloplasty with femoral head resection, also known as the Girdlestone procedure. This procedure involves modifying the shape of the acetabulum, which is the cup-shaped socket of the hip joint, and removing the femoral head, which is the rounded upper end of the femur bone. The aim of this procedure is to alleviate pain in patients with severe hip infections or those who cannot undergo joint reconstruction due to bone limitations.

2. Official Description

The official description of CPT code 27122 is: ‘Acetabuloplasty; resection, femoral head (eg, Girdlestone procedure).’ This code specifically refers to the surgical procedure that involves modifying the acetabulum and resecting the femoral head to alleviate pain and improve hip function.

3. Procedure

1. When performing CPT 27122, 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 vessels.
3. The muscles are then retracted to expose the joint capsule.
4. The provider incises the capsule to enter the joint and dislocates the femoral head from the acetabulum.
5. The acetabulum rim is removed, and the femoral head is resected or cut from the femur bone using a saw.
6. If necessary, the provider may also remove any arthritic or degenerated portion of the acetabulum.
7. The femoral component is not replaced, and the provider closes the hip joint, creating a pseudo joint supported by muscles and fibrous tissue.
8. Hemostasis is achieved at the surgical site, and the wound is closed by suturing the soft tissue in layers.
9. Finally, the patient is placed in a hip cast for a period of four to six weeks to aid in the healing process.

4. Qualifying circumstances

CPT 27122 is performed on patients who have severe hip infections or those whose bones cannot tolerate joint reconstruction. The procedure is intended to alleviate pain and improve hip function in these specific circumstances. It is important to note that this procedure is typically performed by a qualified healthcare professional with expertise in orthopedic surgery.

5. When to use CPT code 27122

CPT code 27122 should be used when a provider performs acetabuloplasty with femoral head resection, specifically the Girdlestone procedure. This code is appropriate for cases where the patient has a severe hip infection or when joint reconstruction is not feasible due to bone limitations. It is important to accurately document the procedure and ensure that it meets the criteria outlined in the official description of CPT code 27122.

6. Documentation requirements

When reporting CPT code 27122, the provider must document the following information:

• Patient’s diagnosis and the need for acetabuloplasty with femoral head resection
• Details of the procedure performed, including any modifications made to the acetabulum and the resection of the femoral head
• Date of the procedure
• Any additional relevant information, such as complications or specific challenges encountered during the surgery
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 27122, it is important to ensure that the procedure performed aligns with the official description of the code. The provider should be qualified and experienced in performing acetabuloplasty with femoral head resection. It is also crucial to follow any specific billing guidelines provided by the payer or insurance company. Additionally, it is important to review any updates or changes to the billing guidelines for CPT code 27122 to ensure accurate reporting.

8. Historical information

CPT code 27122 was added to the Current Procedural Terminology system on January 1, 1990. Over the years, there have been some changes to its status, including being added and removed from the Inpatient Only (IPO) list for Medicare. It is important to stay updated on any historical changes or updates related to CPT code 27122 to ensure accurate reporting and billing.

9. Examples

1. A patient with a severe hip infection undergoes acetabuloplasty with femoral head resection (CPT 27122) to alleviate pain and improve hip function.
2. In a case where a patient’s bones cannot tolerate joint reconstruction, acetabuloplasty with femoral head resection (CPT 27122) is performed to address the hip condition.
3. A qualified orthopedic surgeon performs acetabuloplasty with femoral head resection (CPT 27122) on a patient with a severe hip infection, resulting in pain relief and improved hip function.
4. For a patient with bone limitations that prevent joint reconstruction, acetabuloplasty with femoral head resection (CPT 27122) is performed to address the hip condition and improve the patient’s quality of life.