How To Use CPT Code 27295

CPT 27295 describes the disarticulation of the hip joint, which involves the surgical removal of the entire lower extremity through the hip 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 27295?

CPT 27295 is used to describe the surgical procedure known as disarticulation of the hip joint. This procedure involves the complete removal of the lower extremity through the hip joint. It is typically performed when other treatment options have been exhausted or when there is a need for amputation due to severe trauma or disease.

2. Official Description

The official description of CPT code 27295 is: ‘Disarticulation of hip.’

3. Procedure

1. The surgeon begins by making an incision in the skin just below the anterior superior iliac spine, extending it to the inner and upper portion of the thigh.
2. They then dissect through the subcutaneous tissue to access the hip joint.
3. The femoral vessels are ligated and divided, and the femoral nerve is cut.
4. The different muscles, such as the iliopsoas, gluteus maximus, and hamstrings, are divided from their insertion on the femur.
5. The obturator artery is ligated and divided, and the obturator nerve and sciatic nerve are cut.
6. The surgeon incises the hip joint capsule and divides the ligamentum teres to disarticulate the hip from the pelvis.
7. Hemostasis is achieved at the surgical site, and the wound is closed by suturing the skin flap.

4. Qualifying circumstances

CPT 27295 is performed when there is a need for the complete removal of the lower extremity through the hip joint. This may be due to severe trauma, such as a crush injury or severe infection, or as a result of a disease process that cannot be effectively managed through other treatment options. The decision to perform this procedure is made by the surgeon based on the individual patient’s condition and the expected outcomes.

5. When to use CPT code 27295

CPT code 27295 should be used when the surgeon performs the disarticulation of the hip joint, removing the entire lower extremity through the hip joint. It is important to accurately document the procedure and ensure that it meets the criteria outlined in the official description of the code.

6. Documentation requirements

To support a claim for CPT code 27295, the surgeon must document the following information:

• Patient’s diagnosis and the need for disarticulation of the hip
• Details of the surgical procedure, including the incision site, structures divided, and steps taken to disarticulate the hip
• Any complications or unexpected findings during the procedure
• Post-operative care instructions and follow-up plans
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT code 27295, it is important to ensure that the procedure performed meets the criteria outlined in the official description. The surgeon should also follow any additional guidelines provided by the payer or insurance company. It is important to accurately code and document the procedure to avoid any potential billing or reimbursement issues.

8. Historical information

CPT code 27295 was added to the Current Procedural Terminology system on January 1, 1990. It has undergone several changes over the years, 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 to ensure accurate billing and coding practices.

9. Examples

1. A patient with severe trauma to the lower extremity undergoes disarticulation of the hip joint to remove the affected limb.
2. A patient with a chronic infection in the hip joint undergoes disarticulation of the hip to prevent further spread of the infection.
3. A patient with a malignant tumor in the hip joint undergoes disarticulation of the hip as part of their cancer treatment plan.
4. A patient with a congenital deformity of the hip joint undergoes disarticulation of the hip to improve their mobility and quality of life.
5. A patient with a failed hip replacement surgery undergoes disarticulation of the hip to address complications and restore function.
6. A patient with a severe degenerative joint disease in the hip joint undergoes disarticulation of the hip to alleviate pain and improve their overall quality of life.
7. A patient with a severe vascular disease in the lower extremity undergoes disarticulation of the hip to prevent further complications and improve blood flow.
8. A patient with a severe infection in the hip joint undergoes disarticulation of the hip to remove the source of infection and prevent further spread.
9. A patient with a traumatic injury to the hip joint undergoes disarticulation of the hip to address the damage and restore function.
10. A patient with a severe congenital malformation of the hip joint undergoes disarticulation of the hip to improve their mobility and overall quality of life.