How To Use CPT Code 27254

CPT 27254 describes the open treatment of a traumatic hip joint dislocation, along with the treatment of an acetabular wall and femoral head fracture. 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 27254?

CPT 27254 is used to describe the open treatment of a traumatic hip joint dislocation, along with the treatment of an acetabular wall and femoral head fracture. This procedure may involve the use of internal fixation implants, such as bone screws or wires, to stabilize the dislocation. It is performed by a healthcare provider to realign the bones and restore proper alignment of the hip joint.

2. Official Description

The official description of CPT code 27254 is the open treatment of hip dislocation, traumatic, with acetabular wall and femoral head fracture, with or without internal or external fixation. It is important to note that for the treatment of acetabular fracture with fixation, different codes should be used (27226, 27227).

3. Procedure

1. The healthcare provider begins by making an incision over the dislocated hip joint.
2. They then dissect through the subcutaneous tissue, being careful to protect the nerves and vessels.
3. The muscles are retracted to provide adequate exposure of the hip joint.
4. The provider addresses the fractures of the acetabular wall and femoral head, manually manipulating the hip and leg to realign the bones as necessary.
5. If needed, internal fixation implants such as bone screws or wires may be used to fix the acetabular wall and femoral head.
6. The wound is closed by suturing the skin layers together.
7. In some cases, external fixation or traction may be applied to the hip, especially if there is significant soft tissue damage.
8. An X-ray examination may be performed to confirm the reduction of the dislocation.

4. Qualifying circumstances

CPT 27254 is performed on patients who have experienced a traumatic hip joint dislocation, along with an acetabular wall and femoral head fracture. The procedure may involve the use of internal fixation implants to stabilize the dislocation. It is important to note that there are specific codes for the treatment of acetabular fracture with fixation (27226, 27227).

5. When to use CPT code 27254

CPT code 27254 should be used when a healthcare provider performs the open treatment of a traumatic hip joint dislocation, along with the treatment of an acetabular wall and femoral head fracture. It is important to ensure that the procedure involves the use of internal fixation implants, as this is a key component of the code description.

6. Documentation requirements

To support a claim for CPT 27254, the healthcare provider must document the following information:

• Patient’s diagnosis of traumatic hip joint dislocation, acetabular wall fracture, and femoral head fracture
• Details of the procedure performed, including the use of internal fixation implants
• Date of the procedure
• Any additional procedures or treatments performed
• Any complications or unexpected findings
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 27254, it is important to ensure that the procedure meets the criteria outlined in the code description. The use of internal fixation implants is a key component of this code. It is also important to follow any specific billing guidelines provided by insurance companies or payers. It is recommended to review the official documentation and guidelines for accurate billing and coding.

8. Historical information

CPT 27254 was added to the Current Procedural Terminology system on January 1, 1990. There have been several historical changes to the code, 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 the code.

9. Examples

1. A healthcare provider performs an open treatment of a traumatic hip joint dislocation, along with the treatment of an acetabular wall and femoral head fracture, using internal fixation implants.
2. During the procedure, the provider manually manipulates the hip and leg to realign the bones and fixates the acetabular wall and femoral head using bone screws.
3. After the procedure, an X-ray examination confirms the reduction of the dislocation.
4. Another provider performs the open treatment of a traumatic hip joint dislocation and acetabular wall fracture without the use of internal fixation implants.
5. The provider manually manipulates the hip and leg to realign the bones and closes the wound after the procedure.
6. A different provider performs the open treatment of a traumatic hip joint dislocation, acetabular wall fracture, and femoral head fracture, using a combination of internal and external fixation.
7. The provider manually manipulates the hip and leg to realign the bones, fixates the fractures with bone screws, and applies external fixation to stabilize the hip.
8. After the procedure, the patient’s leg is placed in a brace for additional support.
9. Another provider performs the open treatment of a traumatic hip joint dislocation, acetabular wall fracture, and femoral head fracture, without the use of internal fixation implants.
10. The provider manually manipulates the hip and leg to realign the bones and closes the wound after the procedure.