How To Use CPT Code 27256

CPT 27256 describes the treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; without anesthesia, without manipulation. 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 27256?

CPT 27256 is used to describe the treatment of spontaneous hip dislocation without the use of anesthesia or manipulation. This code is specifically for cases where the dislocation is developmental, congenital, or pathological. The treatment involves the use of abduction, splint, or traction to correct the dislocation and stabilize the hip joint.

2. Official Description

The official description of CPT code 27256 is: ‘Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; without anesthesia, without manipulation.’

3. Procedure

1. In this procedure, the healthcare provider performs a closed treatment of a developmental, congenital, or pathological hip joint dislocation.
2. The provider may perform an X-ray to examine the dislocated hip joint and assess the severity of the dislocation.
3. Depending on the patient’s condition, the provider may choose to stabilize the fracture and manage the pain through various methods.
4. One method is to place the patient’s hip and leg in a spica cast in a position of abduction to immobilize the hip and maintain the correct position.
5. Alternatively, the provider may use a specially designed splint that exerts a continuous force of traction over the leg to reduce the dislocation.
6. In some cases, the provider may use skin traction to gently realign the hip by applying longitudinal force on the leg using weights and pulleys.
7. The provider may perform an X-ray examination of the joint to confirm the reduction of the dislocation.

4. Qualifying circumstances

CPT 27256 is used for the treatment of spontaneous hip dislocation that is developmental, congenital, or pathological. The procedure does not involve the use of anesthesia or manipulation. It is important to note that this code is specific to the treatment of hip dislocation and should not be used for other types of dislocations or fractures.

5. When to use CPT code 27256

CPT code 27256 should be used when a healthcare provider performs the treatment of spontaneous hip dislocation using abduction, splint, or traction without the use of anesthesia or manipulation. It is important to ensure that the dislocation is developmental, congenital, or pathological, and that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 27256, the healthcare provider must document the following information:

• Patient’s diagnosis and the specific type of hip dislocation
• Details of the treatment procedure, including the use of abduction, splint, or traction
• Date of the procedure
• Any X-ray examinations performed and their results
• Any additional instructions or recommendations provided to the patient
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 27256, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the details of the treatment procedure and provide any necessary supporting documentation. CPT code 27256 should not be reported with other codes for anesthesia or manipulation. It is important to review the specific billing guidelines and requirements of the payer to ensure proper reimbursement.

8. Historical information

CPT code 27256 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider performs a closed treatment of a developmental hip dislocation in a pediatric patient using a spica cast for immobilization.
2. A patient with a congenital hip dislocation undergoes treatment with a specially designed splint that applies continuous traction to reduce the dislocation.
3. A provider uses skin traction to gently realign the hip joint in a patient with a pathological hip dislocation.
4. A healthcare provider performs an X-ray examination to assess the severity of a developmental hip dislocation before proceeding with treatment using abduction and splint.
5. A patient with a congenital hip dislocation undergoes treatment with a Pavlik harness, an external support apparatus that holds the hips in flexion and abduction to stabilize the joint.
6. A provider uses skin traction in combination with a spica cast to treat a developmental hip dislocation in an adult patient.
7. A healthcare provider performs a closed treatment of a pathological hip dislocation using abduction and traction without the need for anesthesia or manipulation.
8. A patient with a congenital hip dislocation undergoes treatment with a specially designed splint that exerts continuous traction to reduce the dislocation.
9. A provider uses skin traction to gently realign the hip joint in a patient with a developmental hip dislocation.
10. A healthcare provider performs an X-ray examination to confirm the reduction of a pathological hip dislocation after treatment with abduction and splint.