How To Use CPT Code 27280

CPT 27280 describes the surgical procedure of arthrodesis on the sacroiliac joint. 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 27280?

CPT 27280 is used to describe a surgical procedure known as arthrodesis on the sacroiliac joint. This procedure involves surgically immobilizing the joint in the pelvis by inducing artificial bone generation. It may also include obtaining a bone graft from the patient’s body and using instrumentation, if necessary.

2. Official Description

The official description of CPT code 27280 is: ‘Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation, when performed.’

3. Procedure

1. The provider begins by making an incision over the ilioinguinal area, which is the lower outer area of the abdomen.
2. Using an open approach, the provider dissects through the subcutaneous tissue, preserving the nerves and blood vessels.
3. The provider detaches the abdominal muscles from the ilium to access the sacroiliac joint capsule.
4. The provider cuts the capsule to enter the joint and removes any damaged cartilage.
5. If necessary, the provider obtains a bone graft from nearby bone and packs it into the joint being fused.
6. The provider may use instrumentation, such as K wires, powered staples, plates, or headless screws, to restrict movement and promote fusion.
7. The provider stops any bleeding and closes the wound in layers.

4. Qualifying circumstances

CPT 27280 is performed on patients who require surgical immobilization of the sacroiliac joint. This may be due to conditions such as sacroiliac joint dysfunction or severe pain caused by movement in the joint. The procedure is typically performed by a qualified healthcare professional who has the necessary expertise in performing arthrodesis.

5. When to use CPT code 27280

CPT code 27280 should be used when an open arthrodesis procedure is performed on the sacroiliac joint. It is important to note that this code should not be reported in conjunction with code 0775T. If the procedure is performed using a percutaneous or minimally invasive approach with a transfixation device, CPT code 27279 should be used instead.

6. Documentation requirements

To support a claim for CPT 27280, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for sacroiliac joint arthrodesis
• Details of the procedure, including the use of bone graft and instrumentation
• Date of the procedure
• Any additional relevant information, such as complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 27280, ensure that the procedure meets the criteria for this specific code. It is important to note that CPT code 27280 should not be reported with code 0775T. Additionally, if the procedure is performed bilaterally, modifier 50 should be appended to the code.

8. Historical information

CPT code 27280 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 code description and its inclusion or exclusion from the Inpatient Only (IPO) list for Medicare reimbursement.

9. Examples

1. A patient with sacroiliac joint dysfunction undergoes an open arthrodesis procedure on their sacroiliac joint to alleviate pain and stabilize the joint.
2. A healthcare provider performs an open arthrodesis procedure on a patient with severe sacroiliac joint pain caused by movement in the joint.
3. A patient with a history of sacroiliac joint instability undergoes an open arthrodesis procedure to fuse the joint and improve stability.
4. A healthcare provider performs an open arthrodesis procedure on a patient with sacroiliac joint degeneration to alleviate pain and improve joint function.
5. A patient with a sacroiliac joint fracture undergoes an open arthrodesis procedure to stabilize the joint and promote healing.
6. A healthcare provider performs an open arthrodesis procedure on a patient with sacroiliac joint arthritis to alleviate pain and improve joint function.
7. A patient with sacroiliac joint dislocation undergoes an open arthrodesis procedure to realign and stabilize the joint.
8. A healthcare provider performs an open arthrodesis procedure on a patient with sacroiliac joint infection to remove infected tissue and promote healing.
9. A patient with severe sacroiliac joint pain caused by movement in the joint undergoes an open arthrodesis procedure to stabilize the joint and alleviate pain.
10. A healthcare provider performs an open arthrodesis procedure on a patient with sacroiliac joint instability to improve joint stability and prevent further damage.