How To Use CPT Code 27197

CPT 27197 describes the closed treatment of fractures and/or dislocations in the posterior pelvic ring, including the ilium, sacroiliac joint, and/or sacrum, without manipulation. 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 27197?

CPT 27197 is used to describe the closed treatment of fractures and/or dislocations in the posterior pelvic ring, without manipulation. This code is specifically for fractures and/or dislocations in the back (posterior) part of the pelvic bones, including the ilium, sacroiliac joint, and/or sacrum. The treatment does not involve any manipulation of the fracture.

2. Official Description

The official description of CPT code 27197 is: ‘Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; without manipulation.’

3. Procedure

1. The provider treats fractures and/or dislocations in the posterior pelvic ring, including the ilium, sacroiliac joint, and/or sacrum.
2. The treatment is performed without any manipulation of the fracture.
3. The procedure may involve bed rest, compression, strapping, casting, or traction.

4. Qualifying circumstances

CPT 27197 is used for patients with fractures and/or dislocations in the posterior pelvic ring, including the ilium, sacroiliac joint, and/or sacrum. The treatment does not involve any manipulation of the fracture. It may include complete or partial separation (dislocation, diastasis, or subluxation) of the upper part of the pelvic bone (ilium), the sacroiliac joint, or the sacrum. The injury may or may not include fractures or dislocations in the anterior pelvic ring, pubic symphysis, and/or superior/inferior rami.

5. When to use CPT code 27197

CPT code 27197 should be used when the provider performs closed treatment of fractures and/or dislocations in the posterior pelvic ring, including the ilium, sacroiliac joint, and/or sacrum, without any manipulation of the fracture. It should not be reported for anterior pelvic ring fractures or dislocations, or if manipulation of the fracture is performed.

6. Documentation requirements

To support a claim for CPT 27197, the provider must document the following information:

• Diagnosis of fractures and/or dislocations in the posterior pelvic ring
• Details of the treatment performed, including any specific procedures or techniques used
• Date of the treatment
• Any additional services provided, such as E/M services
• Signature of the provider

7. Billing guidelines

When billing for CPT 27197, ensure that the treatment performed is for fractures and/or dislocations in the posterior pelvic ring, without any manipulation. It should not be reported for anterior pelvic ring fractures or dislocations. If the treatment involves percutaneous procedures, report the appropriate percutaneous treatment code. If the treatment involves open procedures with manipulation, report the appropriate open treatment code. CPT 27197 has a 0 global day period.

8. Historical information

CPT 27197 was added to the Current Procedural Terminology system on January 1, 2017. There have been no updates to the code since its addition.

9. Examples

1. A patient presents with a fracture in the posterior pelvic ring, involving the sacroiliac joint. The provider performs closed treatment of the fracture without any manipulation.
2. A patient sustains a dislocation of the ilium in the posterior pelvic ring. The provider performs closed treatment of the dislocation without any manipulation.
3. A patient has a fracture in the sacrum, without any associated fractures or dislocations in the anterior pelvic ring. The provider performs closed treatment of the fracture without any manipulation.
4. A patient presents with a dislocation of the sacroiliac joint in the posterior pelvic ring. The provider performs closed treatment of the dislocation without any manipulation.
5. A patient has a fracture in the ilium, without any associated fractures or dislocations in the anterior pelvic ring. The provider performs closed treatment of the fracture without any manipulation.
6. A patient sustains a dislocation of the sacrum in the posterior pelvic ring. The provider performs closed treatment of the dislocation without any manipulation.
7. A patient presents with a fracture in the posterior pelvic ring, involving the ilium and sacroiliac joint. The provider performs closed treatment of the fracture without any manipulation.
8. A patient has a dislocation of the ilium and sacrum in the posterior pelvic ring. The provider performs closed treatment of the dislocation without any manipulation.
9. A patient sustains a fracture in the sacroiliac joint, without any associated fractures or dislocations in the anterior pelvic ring. The provider performs closed treatment of the fracture without any manipulation.
10. A patient presents with a dislocation of the ilium and sacroiliac joint in the posterior pelvic ring. The provider performs closed treatment of the dislocation without any manipulation.