How To Use CPT Code 27290

CPT 27290 describes the procedure for interpelviabdominal amputation, also known as hindquarter amputation. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 27290?

CPT 27290 can be used to describe the surgical procedure of interpelviabdominal amputation, which involves the complete removal of an entire leg along with one outer half of the pelvis on the same side. This procedure is typically performed in rare cases of severe trauma, infection, or tumor.

2. Official Description

The official description of CPT code 27290 is: ‘Interpelviabdominal amputation (hindquarter amputation).’ This code is used to report the surgical removal of an entire leg along with one outer half of the pelvis on the same side.

3. Procedure

1. The provider begins by creating separate incisions in the front and back of the pelvis and between the thighs.
2. Next, the provider ligates the iliac vessels and retracts the nerves.
3. The iliac wing is then divided from the back, and the symphysis pubis is disarticulated in front.
4. All major muscles to the leg are removed, and the gluteal muscle flap is pulled in front for final closure.
5. The wound is irrigated with antibiotics, and the flaps are sutured and packed with antiseptic gauze.
6. A temporary drain may be left in place to remove excess fluid.

4. Qualifying circumstances

CPT 27290 is performed in cases of severe trauma, infection, or tumor that require the complete removal of an entire leg along with one outer half of the pelvis on the same side. This procedure is typically performed by a qualified provider in rare and specific circumstances.

5. When to use CPT code 27290

CPT code 27290 should be used when the interpelviabdominal amputation procedure is performed. It is important to ensure that the procedure meets the specific criteria outlined in the official description. This code should not be used for other types of amputations or procedures.

6. Documentation requirements

To support a claim for CPT 27290, the provider must document the following information:

• Reason for the interpelviabdominal amputation procedure
• Details of the surgical technique used
• Date of the procedure
• Any additional procedures or services performed during the same operative session
• Any complications or unexpected findings
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 27290, ensure that the procedure performed meets the criteria outlined in the official description. It is important to accurately report the procedure code and any additional codes that may be necessary to fully describe the services provided. Follow the appropriate coding guidelines and modifiers as required by the payer.

8. Historical information

CPT 27290 was added to the Current Procedural Terminology system on January 1, 1990. It was initially listed as an inpatient-only (IPO) procedure, but it was later removed from the IPO list in 2021. However, it was added back to the IPO list in 2022.

9. Examples

1. A patient undergoes interpelviabdominal amputation due to severe trauma resulting from a car accident.
2. A patient with a malignant tumor in the pelvis undergoes hindquarter amputation to remove the affected leg and outer half of the pelvis.
3. A patient with a severe infection in the leg and pelvis requires interpelviabdominal amputation to prevent further spread of the infection.
4. A patient with a rare congenital condition undergoes hindquarter amputation for functional and cosmetic reasons.
5. A patient with a recurrent tumor in the pelvis undergoes interpelviabdominal amputation as part of their cancer treatment plan.
6. A patient with extensive trauma to the leg and pelvis undergoes hindquarter amputation to improve their overall quality of life.
7. A patient with a large tumor in the pelvis undergoes interpelviabdominal amputation to achieve complete tumor removal.
8. A patient with a severe infection in the leg and pelvis undergoes hindquarter amputation to prevent the spread of infection and improve their overall health.
9. A patient with a rare vascular condition undergoes interpelviabdominal amputation to alleviate their symptoms and improve their mobility.
10. A patient with a malignant tumor in the pelvis undergoes hindquarter amputation as part of their cancer treatment plan.