How To Use CPT Code 27218

CPT 27218 describes the open treatment of a posterior pelvic bone fracture and/or dislocation with fracture patterns that disrupt 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 27218?

CPT 27218 can be used to describe the open treatment of a posterior pelvic bone fracture and/or dislocation on one side of the pelvis. This code is used when the provider performs a surgical procedure to realign and stabilize the fractured or dislocated bone using internal fixation, such as plates and screws.

2. Official Description

The official description of CPT code 27218 is: ‘Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes ipsilateral ilium, sacroiliac joint and/or sacrum).’ This code also includes a note to report it with modifier 50 for bilateral procedures. For percutaneous/minimally invasive arthrodesis of the sacroiliac joint without fracture and/or dislocation, use CPT code 27279.

3. Procedure

1. The provider makes an incision over the site of the pelvic injury after the patient is appropriately prepped and anesthetized.
2. He then dissects through the subcutaneous tissue, protecting the nerves and vessels.
3. The provider retracts the muscles to expose the pelvis adequately.
4. He manually adjusts the fractured or dislocated bone to realign it, if necessary.
5. The provider stabilizes the reduced bone using internal fixation, such as plates and screws.
6. Drains may be placed, and the wound is closed by suturing the skin layers together.
7. An X-ray examination may be performed to confirm the reduction of the fracture.

4. Qualifying circumstances

CPT 27218 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 involves open treatment and internal fixation. It is important to note that this code is used for unilateral procedures. For bilateral procedures, modifier 50 should be appended to the code.

5. When to use CPT code 27218

CPT code 27218 should be used when the provider performs an open treatment of a posterior pelvic bone fracture and/or dislocation on one side of the pelvis. It is appropriate to use this code when the procedure involves the use of internal fixation, such as plates and screws, to stabilize the fracture. If the procedure is performed percutaneously or involves arthrodesis of the sacroiliac joint without fracture and/or dislocation, a different code should be used.

6. Documentation requirements

To support a claim for CPT code 27218, the provider must document the following information:

• Patient’s diagnosis of a posterior pelvic bone fracture and/or dislocation
• Details of the procedure performed, including the use of internal fixation
• Date of the procedure
• Start and end time of the procedure
• Confirmation of reduction of the fracture, if applicable
• Any additional procedures or interventions performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 27218, ensure that the procedure meets the criteria for open treatment of a posterior pelvic bone fracture and/or dislocation on one side of the pelvis. If the procedure is performed bilaterally, modifier 50 should be appended to the code. It is important to use the appropriate code based on the specific procedure performed. If the procedure involves percutaneous/minimally invasive arthrodesis of the sacroiliac joint without fracture and/or dislocation, a different code should be used.

8. Historical information

CPT code 27218 was added to the Current Procedural Terminology system on January 1, 1993. There was a code change on January 1, 2009, which updated the description to include the specific structures involved in the procedure.

9. Examples

1. A patient sustains a posterior pelvic bone fracture on one side of the pelvis due to a fall. The provider performs an open treatment of the fracture, realigning the bone and stabilizing it with plates and screws.
2. Following a car accident, a patient presents with a dislocated posterior pelvic bone on one side. The provider performs an open reduction of the dislocation and uses internal fixation to stabilize the bone.
3. A patient with a history of osteoporosis experiences a fracture in the posterior pelvic bone on one side. The provider performs an open treatment of the fracture, using plates and screws to stabilize the bone.
4. During a sports activity, a patient falls and fractures the posterior pelvic bone on one side. The provider performs an open reduction of the fracture and uses internal fixation to stabilize the bone.
5. A patient involved in a motorcycle accident sustains a dislocated posterior pelvic bone on one side. The provider performs an open reduction of the dislocation and uses plates and screws to stabilize the bone.