How To Use CPT Code 27305

CPT 27305 describes a specific surgical procedure involving the iliotibial band, which is a thick band of fibers running along the outside of the hip and thigh. This article will provide an overview of CPT code 27305, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 27305?

CPT 27305 is a code used to describe a surgical procedure known as iliotibial tenotomy. This procedure involves the surgical division or cutting of the iliotibial band, which is a thick band of fibers located on the outside of the hip and thigh. It is typically performed to treat iliotibial band tightness that causes pain around the knee joint. The provider makes an incision in the skin over the outer part of the knee, exposes the iliotibial band, and then lengthens it by incising it. This allows the band to return to its normal length, correcting the deformity and relieving the associated pain.

2. Official Description

The official description of CPT code 27305 is: ‘Fasciotomy, iliotibial (tenotomy), open.’

3. Procedure

1. In this procedure, the provider begins by making an incision in the skin over the outer part of the knee.
2. They then dissect through the subcutaneous tissue to gain access to the iliotibial band.
3. Once the iliotibial band is adequately exposed, the provider incises it to lengthen it.
4. This allows the band to return to its normal length, correcting any deformity and relieving pain.
5. Finally, the provider achieves hemostasis at the surgical site and closes the wound by suturing the soft tissue in layers.

4. Qualifying circumstances

CPT 27305 is typically performed to treat iliotibial band tightness that causes pain around the knee joint. It is important to note that this procedure is only appropriate for patients who have a specific deformity caused by congenital or acquired shortening of the muscle. The provider must assess the patient’s condition and determine that iliotibial tenotomy is the appropriate treatment option. It is crucial to meet the specific criteria for this procedure to ensure accurate coding and billing.

5. When to use CPT code 27305

CPT code 27305 should be used when the provider performs an open tenotomy of the iliotibial band to correct a deformity caused by muscle shortening. It is important to ensure that the procedure meets the qualifying circumstances mentioned earlier. This code should not be used for any other procedures or conditions.

6. Documentation requirements

To support a claim for CPT 27305, the provider must document the following information:

• Patient’s diagnosis and the need for iliotibial tenotomy
• Details of the procedure, including the incision, dissection, incision of the iliotibial band, and closure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27305, it is important to ensure that the procedure performed meets the specific criteria for iliotibial tenotomy. This code should not be reported with other codes unless additional procedures were performed. It is crucial to follow the appropriate coding guidelines and accurately document the procedure to ensure proper reimbursement.

8. Historical information

CPT code 27305 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 patient with iliotibial band tightness undergoes an open tenotomy of the iliotibial band to correct the deformity causing knee pain.
2. A provider performs an iliotibial tenotomy on a patient with a congenital muscle shortening deformity.
3. A patient with acquired muscle shortening undergoes an open tenotomy of the iliotibial band to relieve pain and correct the deformity.
4. A provider performs an iliotibial tenotomy on a patient with a history of knee pain and confirmed iliotibial band tightness.
5. A patient with a specific deformity caused by muscle shortening undergoes an open tenotomy of the iliotibial band to improve knee joint function.
6. A provider performs an iliotibial tenotomy on a patient with a congenital condition affecting the iliotibial band.
7. A patient with chronic knee pain undergoes an open tenotomy of the iliotibial band to alleviate symptoms and improve mobility.
8. A provider performs an iliotibial tenotomy on a patient with a history of failed conservative treatments for iliotibial band tightness.
9. A patient with a confirmed muscle shortening deformity undergoes an open tenotomy of the iliotibial band to correct the issue and relieve pain.
10. A provider performs an iliotibial tenotomy on a patient with a recent injury resulting in iliotibial band tightness and knee pain.