How To Use CPT Code 27248

CPT 27248 describes the open treatment of a greater trochanteric fracture in the upper end of the femur, including internal fixation if performed. 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 27248?

CPT 27248 can be used to describe the open treatment of a greater trochanteric fracture in the upper end of the femur. This procedure involves making an incision in the skin over the fractured bone, dissecting through the subcutaneous tissue, and protecting the nerves and vessels. The provider then exposes the greater trochanter of the femur, adjusts the bone to reduce the fractured fragments, and uses implants like screws, nails, or wires to fix the fracture. The wound is closed by suturing the skin layers together, and the patient’s leg is placed in a brace or splint for four to six weeks.

2. Official Description

The official description of CPT code 27248 is: ‘Open treatment of greater trochanteric fracture, includes internal fixation, when performed.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. An incision is made in the skin over the fractured bone.
3. The provider dissects through the subcutaneous tissue, protecting the nerves and vessels.
4. The muscles are separated and retracted to expose the greater trochanter of the femur.
5. The provider adjusts the bone to reduce the fractured fragments.
6. Implants like screws, nails, or wires are used to fix the fracture.
7. The wound is closed by suturing the skin layers together.
8. The patient’s leg is placed in a brace or splint for four to six weeks.
9. An X-ray examination may be performed to confirm the reduction of the fracture.

4. Qualifying circumstances

CPT 27248 is performed when a patient has a greater trochanteric fracture in the upper end of the femur that requires open treatment. The procedure may include internal fixation using implants like screws, nails, or wires. The patient must meet the criteria for this specific fracture and the provider must determine that open treatment with internal fixation is necessary.

5. When to use CPT code 27248

CPT code 27248 should be used when a provider performs the open treatment of a greater trochanteric fracture in the upper end of the femur, including internal fixation if performed. This code should not be used for closed treatment of the fracture without manipulation.

6. Documentation requirements

To support a claim for CPT 27248, the provider must document the following information:

• Patient’s diagnosis of a greater trochanteric fracture
• Details of the procedure performed, including the use of internal fixation if applicable
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures or services provided
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27248, ensure that the procedure performed meets the criteria for open treatment of a greater trochanteric fracture with internal fixation. It is important to accurately document the details of the procedure and any additional services provided. CPT code 27248 should not be reported with other codes unless additional procedures or services were performed. It is also important to follow any specific billing guidelines provided by insurance carriers or payers.

8. Historical information

CPT 27248 was added to the Current Procedural Terminology system on January 1, 1990. There have been several historical changes to the code, including updates to the description and its inclusion on the Inpatient Only (IPO) list for Medicare. It was removed from the IPO list in 2021 and then added back in 2022.

9. Examples

1. A patient undergoes open treatment of a greater trochanteric fracture in the upper end of the femur, including internal fixation with screws.
2. A provider performs open treatment of a greater trochanteric fracture in the upper end of the femur, using nails for internal fixation.
3. A patient with a greater trochanteric fracture undergoes open treatment with wires for internal fixation.
4. A provider performs open treatment of a greater trochanteric fracture in the upper end of the femur, using a combination of screws and wires for internal fixation.
5. An individual undergoes open treatment of a greater trochanteric fracture in the upper end of the femur, with the use of a plate for internal fixation.
6. A provider performs open treatment of a greater trochanteric fracture in the upper end of the femur, using a combination of screws, nails, and wires for internal fixation.
7. A patient undergoes open treatment of a greater trochanteric fracture in the upper end of the femur, with the use of an intramedullary implant for internal fixation.
8. A provider performs open treatment of a greater trochanteric fracture in the upper end of the femur, using locking screws for internal fixation.
9. An individual undergoes open treatment of a greater trochanteric fracture in the upper end of the femur, with the use of cerclage and locking screws for internal fixation.
10. A patient with a greater trochanteric fracture undergoes open treatment, with the use of external fixation in addition to internal fixation with screws.