How To Use CPT Code 27216

CPT 27216 describes the percutaneous skeletal fixation of a posterior pelvic bone fracture and/or dislocation that disrupts the pelvic ring on one side of the pelvis. 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 27216?

CPT 27216 is used to describe a percutaneous skeletal fixation procedure for a posterior pelvic bone fracture and/or dislocation that disrupts the pelvic ring on one side of the pelvis. The provider inserts pins through the skin and into the pelvic bone, attaching a frame to stabilize and reduce the fracture or dislocation. This code is used for unilateral procedures, but if the procedure is performed bilaterally, modifier 50 should be appended to the code.

2. Official Description

The official description of CPT code 27216 is: ‘Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral (includes ipsilateral ilium, sacroiliac joint and/or sacrum).’ It is important to note that for percutaneous/minimally invasive arthrodesis of the sacroiliac joint without fracture and/or dislocation, a different code, 27279, should be used.

3. Procedure

1. When performing CPT 27216, the provider begins by appropriately prepping and anesthetizing the patient.
2. Pins and screws are then inserted through the skin at angles into the pelvic bone.
3. A skeletal fixation device is attached to the pins, and clamps are applied and tightened to provide fixation and gradually reduce the fracture or dislocation.

4. Qualifying circumstances

CPT 27216 is used for patients with a posterior pelvic bone fracture and/or dislocation that disrupts the pelvic ring on one side of the pelvis. The procedure is performed by a provider who inserts pins and attaches a skeletal fixation device to stabilize and reduce the fracture or dislocation. It is important to note that this code is used for unilateral procedures, and if the procedure is performed bilaterally, modifier 50 should be appended to the code.

5. When to use CPT code 27216

CPT code 27216 should be used when a provider performs a percutaneous skeletal fixation procedure for a posterior pelvic bone fracture and/or dislocation that disrupts the pelvic ring on one side of the pelvis. It is important to ensure that the procedure is unilateral and not bilateral. If the procedure is performed bilaterally, modifier 50 should be appended to the code.

6. Documentation requirements

To support a claim for CPT 27216, the provider must document the following information:

• Patient’s diagnosis of a posterior pelvic bone fracture and/or dislocation
• Procedure performed, including the insertion of pins and attachment of a skeletal fixation device
• Unilateral nature of the procedure
• Date of the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27216, it is important to ensure that the procedure is unilateral and not bilateral. If the procedure is performed bilaterally, modifier 50 should be appended to the code. It is also important to follow any specific guidelines provided by the payer regarding documentation and billing for this procedure.

8. Historical information

CPT 27216 was added to the Current Procedural Terminology system on January 1, 1993. On January 1, 2009, the code description was updated to include the specific structures involved in the procedure.

9. Examples

1. A provider performs a percutaneous skeletal fixation procedure for a posterior pelvic bone fracture that disrupts the pelvic ring on one side of the pelvis.
2. A patient presents with a dislocation of the sacroiliac joint on one side of the pelvis, and the provider performs a percutaneous skeletal fixation procedure to stabilize and reduce the dislocation.
3. A unilateral fracture of the ilium is identified in a patient, and the provider performs a percutaneous skeletal fixation procedure to stabilize and reduce the fracture.
4. A patient sustains a posterior pelvic bone fracture that disrupts the pelvic ring on one side of the pelvis, and the provider performs a percutaneous skeletal fixation procedure to stabilize and reduce the fracture.
5. A dislocation of the sacrum is identified in a patient, and the provider performs a percutaneous skeletal fixation procedure to stabilize and reduce the dislocation.
6. A provider performs a percutaneous skeletal fixation procedure for a posterior pelvic bone fracture and/or dislocation that disrupts the pelvic ring on one side of the pelvis.
7. A patient presents with a dislocation of the sacroiliac joint on one side of the pelvis, and the provider performs a percutaneous skeletal fixation procedure to stabilize and reduce the dislocation.
8. A unilateral fracture of the ilium is identified in a patient, and the provider performs a percutaneous skeletal fixation procedure to stabilize and reduce the fracture.