How To Use CPT Code 27232

CPT 27232 describes the closed treatment of a femoral fracture in the proximal end or neck of the femur. 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 27232?

CPT 27232 is used to describe the closed treatment of a femoral fracture in the proximal end or neck of the femur. This procedure involves manipulating the fractured bone and may also include the use of skeletal traction. The provider performs this treatment without making a surgical incision.

2. Official Description

The official description of CPT code 27232 is: ‘Closed treatment of femoral fracture, proximal end, neck; with manipulation, with or without skeletal traction.’

3. Procedure

1. The provider begins by appropriately prepping and anesthetizing the patient.
2. Next, the provider adjusts the fractured fragment by flexing the patient’s hip and exerting a pushing or pulling force on the hip and upper end of the femur to realign the fracture.
3. In some cases, the provider may use skeletal traction, which involves applying force via a pin, wire, screw, or clamp that penetrates the bone. Ropes and heavier weights are then attached to the implant to stabilize and reinforce the fracture fragments.
4. The provider may also apply a skin traction technique, such as Buck’s traction, which uses light weights and counterweights attached to the skin or a traction boot to bring together the fractured bone.
5. After the manipulation and traction, the provider may place the patient’s leg in a brace or splint to support the healing process.

4. Qualifying circumstances

CPT 27232 is performed on patients with a femoral fracture in the proximal end or neck of the femur. The procedure is appropriate for fractures that can be treated without making a surgical incision. The provider must perform manipulation of the fractured bone and may use skeletal traction if necessary.

5. When to use CPT code 27232

CPT code 27232 should be used when the provider performs a closed treatment of a femoral fracture in the proximal end or neck of the femur. This code is appropriate when manipulation of the fractured bone is performed, with or without the use of skeletal traction. If the provider performs percutaneous skeletal fixation or an open treatment with internal fixation or prosthetic replacement, different codes should be used.

6. Documentation requirements

To support a claim for CPT 27232, the provider must document the following information:

• Patient’s diagnosis of a femoral fracture in the proximal end or neck
• Description of the closed treatment procedure performed, including manipulation and use of skeletal traction if applicable
• Date of the procedure
• Any additional procedures or techniques used during the treatment
• Details of any braces or splints applied
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27232, ensure that the procedure meets the criteria for closed treatment of a femoral fracture in the proximal end or neck. The provider should document the manipulation and use of skeletal traction if applicable. It is important to note that CPT code 27232 should not be reported if the provider performs percutaneous skeletal fixation or an open treatment with internal fixation or prosthetic replacement. Additional tips for reporting CPT code 27232 may include specific modifiers or considerations for certain payer guidelines.

8. Historical information

CPT code 27232 was added to the Current Procedural Terminology system on January 1, 1990. 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 revisions to ensure accurate reporting.

9. Examples

1. A patient sustains a femoral fracture in the proximal end or neck, and the provider performs closed treatment with manipulation and skeletal traction.
2. A provider treats a patient with a femoral fracture in the proximal end or neck using closed treatment with manipulation and without skeletal traction.
3. A patient presents with a femoral fracture in the proximal end or neck, and the provider performs closed treatment with manipulation and applies a brace for support.
4. A provider treats a patient with a femoral fracture in the proximal end or neck using closed treatment with manipulation and Buck’s traction.
5. A patient undergoes closed treatment with manipulation and skeletal traction for a femoral fracture in the proximal end or neck, followed by placement in a splint.
6. A provider performs closed treatment with manipulation and skeletal traction for a femoral fracture in the proximal end or neck, without the need for a brace or splint.
7. A patient receives closed treatment with manipulation and skeletal traction for a femoral fracture in the proximal end or neck, followed by the application of a traction boot.
8. A provider performs closed treatment with manipulation and skeletal traction for a femoral fracture in the proximal end or neck, with the use of Kirschner wires for stabilization.
9. A patient undergoes closed treatment with manipulation and skeletal traction for a femoral fracture in the proximal end or neck, followed by the application of a cast.
10. A provider treats a patient with a femoral fracture in the proximal end or neck using closed treatment with manipulation and skeletal traction, with the addition of physical therapy for rehabilitation.