How To Use CPT Code 27198

CPT 27198 describes the closed treatment of posterior pelvic ring fractures, dislocations, diastasis, or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fractures and/or dislocations of the pubic symphysis and/or superior/inferior rami, requiring more than local anesthesia. 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 27198?

CPT 27198 can be used to describe the closed treatment of fractures, dislocations, diastasis, or subluxation of the posterior pelvic ring, including the ilium, sacroiliac joint, and/or sacrum. This code is used when the treatment requires more than local anesthesia and may involve manipulation of the fracture or separation. It may also include anterior pelvic ring fractures and/or dislocations of the pubic symphysis and/or superior/inferior rami.

2. Official Description

The official description of CPT code 27198 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; with manipulation, requiring more than local anesthesia (ie, general anesthesia, moderate sedation, spinal/epidural).’

3. Procedure

1. The provider administers general anesthesia, regional anesthesia, or moderate sedation to the patient.
2. The provider performs closed manipulation to treat the fracture and/or separation of the posterior pelvic ring.
3. If necessary, the provider may also address any anterior pelvic ring fractures and/or dislocations of the pubic symphysis and/or superior/inferior rami.
4. Additional treatment options may include bed rest, compression, strapping, casting, or traction.

4. Qualifying circumstances

CPT 27198 is used for patients with fractures, dislocations, diastasis, or subluxation of the posterior pelvic ring, including the ilium, sacroiliac joint, and/or sacrum. The treatment may also involve anterior pelvic ring fractures and/or dislocations of the pubic symphysis and/or superior/inferior rami. The procedure requires more than local anesthesia, such as general anesthesia, moderate sedation, or spinal/epidural anesthesia.

5. When to use CPT code 27198

CPT code 27198 should be used when the provider performs closed treatment of fractures, dislocations, diastasis, or subluxation of the posterior pelvic ring, with or without anterior pelvic ring fractures and/or dislocations of the pubic symphysis and/or superior/inferior rami. The procedure must require more than local anesthesia, such as general anesthesia, moderate sedation, or spinal/epidural anesthesia.

6. Documentation requirements

To support a claim for CPT 27198, the provider must document the following information:

• Patient’s diagnosis and the need for closed treatment of the posterior pelvic ring
• Details of the procedure, including the use of anesthesia and manipulation
• Any additional treatment provided, such as bed rest, compression, strapping, casting, or traction
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27198, ensure that the procedure meets the requirements outlined in the official description. The treatment must involve closed manipulation of fractures, dislocations, diastasis, or subluxation of the posterior pelvic ring, with or without anterior pelvic ring fractures and/or dislocations of the pubic symphysis and/or superior/inferior rami. The procedure must also require more than local anesthesia. It is important to follow any additional guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 27198 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 undergoes closed treatment of a posterior pelvic ring fracture with manipulation, requiring general anesthesia.
2. A provider performs closed treatment of a dislocation of the sacroiliac joint, with manipulation, requiring moderate sedation.
3. A patient receives closed treatment of a diastasis of the pubic symphysis, with manipulation, requiring spinal anesthesia.
4. A provider treats a subluxation of the ilium and sacrum, with manipulation, requiring general anesthesia.
5. A patient undergoes closed treatment of a posterior pelvic ring fracture and dislocation of the superior rami, with manipulation, requiring moderate sedation.
6. A provider performs closed treatment of a dislocation of the sacrum and inferior rami, with manipulation, requiring general anesthesia.
7. A patient receives closed treatment of a subluxation of the ilium and sacroiliac joint, with manipulation, requiring spinal anesthesia.