How To Use CPT Code 27227

CPT 27227 describes the open treatment of acetabular fractures involving the anterior or posterior column, or a transverse fracture across the acetabulum, with internal fixation. 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 27227?

CPT 27227 is used to describe the open treatment of acetabular fractures. This procedure involves the fixation of fractures in the anterior or posterior column of the acetabulum, or fractures that run transversely across the acetabulum. The provider uses internal fixation implants, such as plates, pins, wires, or screws, to stabilize the fracture and promote proper healing.

2. Official Description

The official description of CPT code 27227 is: ‘Open treatment of acetabular fracture(s) involving anterior or posterior (one) column, or a fracture running transversely across the acetabulum, with internal fixation.’

3. Procedure

1. The provider begins by making an incision in the skin over the hip joint.
2. They then dissect through the subcutaneous tissue, being careful to protect the nerves and vessels.
3. The muscles are retracted to expose the acetabulum.
4. The provider inspects the acetabulum and removes any fracture fragments.
5. Next, they reduce the fracture by aligning the broken bones.
6. The provider then uses internal fixation implants, such as plates, screws, nails, or wires, to stabilize the fracture and hold the bones in place.
7. The wound is closed by suturing the layers of the skin together.
8. A brace or splint may be applied to limit stress on the fractured bones during the healing process.

4. Qualifying circumstances

CPT 27227 is performed on patients with acetabular fractures involving the anterior or posterior column, or transverse fractures across the acetabulum. These fractures may result from trauma or injury. The procedure is typically performed by a qualified healthcare professional, such as an orthopedic surgeon, who has the necessary expertise in open fracture treatment and internal fixation techniques.

5. When to use CPT code 27227

CPT code 27227 should be used when the provider performs an open treatment of acetabular fractures involving the anterior or posterior column, or transverse fractures across the acetabulum. This code is appropriate when internal fixation implants are used to stabilize the fracture and promote proper healing. It is important to accurately document the specific details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT 27227, the provider must document the following information:

• Patient’s diagnosis of acetabular fracture
• Description of the fracture, including whether it involves the anterior or posterior column or is transverse
• Details of the procedure, including the specific internal fixation implants used
• Incision site and size
• Any additional procedures performed, such as removal of fracture fragments
• Any complications or unexpected findings
• Postoperative care instructions
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27227, ensure that the procedure meets the criteria for this code, including the involvement of the anterior or posterior column or a transverse fracture across the acetabulum. It is important to accurately document the details of the procedure to support the use of this code. Additionally, be aware of any specific billing guidelines or requirements from insurance payers or regulatory bodies.

8. Historical information

CPT 27227 was added to the Current Procedural Terminology system on January 1, 1993. There have been several changes to the code over the years, including being added and removed from the Inpatient Only (IPO) list for Medicare. It is important to stay updated on any changes or updates to ensure accurate coding and billing.

9. Examples

1. A patient sustains an acetabular fracture involving the anterior column due to a car accident. The orthopedic surgeon performs an open treatment of the fracture using plates and screws for internal fixation.
2. An individual falls from a height and fractures their acetabulum in a transverse pattern. The orthopedic surgeon performs an open treatment of the fracture, using wires and screws to stabilize the bones.
3. A patient presents with a posterior column fracture of the acetabulum following a sports injury. The orthopedic surgeon performs an open treatment of the fracture, utilizing nails and plates for internal fixation.
4. An elderly patient experiences a fall and sustains an acetabular fracture involving the anterior and posterior columns. The orthopedic surgeon performs an open treatment of the fracture, using screws and interfragmentary compression for stabilization.
5. A young adult is involved in a motorcycle accident and fractures their acetabulum in a transverse pattern with posterior wall involvement. The orthopedic surgeon performs an open treatment of the fracture, utilizing plates and screws for internal fixation, along with skeletal traction.