How To Use CPT Code 27364

CPT 27364 describes the extensive surgical removal of a soft tissue tumor and surrounding tissues in the thigh or knee area, measuring 5cm or more. 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 27364?

CPT 27364 is used to describe the extensive surgical removal of a soft tissue tumor and surrounding tissues in the thigh or knee area, measuring 5cm or more. This code is used when the physician makes an incision over the skin above the tumor, dissects the tumor away from the surrounding structures, excises the tumor along with surrounding tissue, and prepares the tumor and surrounding tissue for pathology. The incision is then closed, and the wound is irrigated.

2. Official Description

The official description of CPT code 27364 is: ‘Radical resection of tumor (eg, sarcoma), soft tissue of thigh or knee area; 5 cm or greater.’ It is important to note that this code is specifically for the surgical removal of soft tissue tumors and not for tumors of cutaneous origin.

3. Procedure

1. The physician makes an incision over the skin above the tumor.
2. The tumor is dissected away from the surrounding structures.
3. Neurovascular structures that may require ligation and/or incision are identified and preserved as much as possible.
4. The tumor, along with surrounding tissue, is excised.
5. The excised tumor and surrounding tissue are prepared for pathology.
6. The patient’s wound is irrigated.
7. The incision is closed.

4. Qualifying circumstances

CPT 27364 is used for patients who require extensive surgical removal of a soft tissue tumor in the thigh or knee area, measuring 5cm or more. It is important to note that this code is specifically for tumors of sarcoma origin and not for tumors of cutaneous origin.

5. When to use CPT code 27364

CPT code 27364 should be used when the physician performs an extensive surgical removal of a soft tissue tumor in the thigh or knee area, measuring 5cm or more. It is important to accurately document the size and depth of the tumor and the surrounding tissues in order to select the appropriate code.

6. Documentation requirements

To support a claim for CPT 27364, the physician must document the following information:

• Size of the tumor and surrounding tissues
• Depth of the surgery
• Incision technique
• Dissection technique
• Identification and preservation of neurovascular structures
• Preparation of the excised tumor and surrounding tissue for pathology
• Irrigation of the patient’s wound
• Closure of the incision

7. Billing guidelines

When billing for CPT 27364, ensure that the surgery meets the criteria for extensive surgical removal of a soft tissue tumor in the thigh or knee area, measuring 5cm or more. It is important to accurately document the size and depth of the tumor and the surrounding tissues. Modifier 80 should be appended if a surgical assistant is involved in the procedure. If a nonphysician practitioner serves as an assistant surgeon, modifier AS should be used instead. It is also important to review the payer’s guidelines to determine if they accept the assistant surgeon’s charge.

8. Historical information

CPT 27364 was added to the Current Procedural Terminology system on January 1, 2010. It was revised on January 1, 2014 to replace ‘neoplasm’ with ‘sarcoma’ in the code description.

9. Examples

1. A physician performs an extensive surgical removal of a soft tissue tumor measuring 7cm in the thigh area.
2. A surgeon excises a soft tissue tumor measuring 6cm in the knee area, along with surrounding tissues.
3. A patient undergoes surgery for the removal of a soft tissue tumor measuring 8cm in the thigh area, with preservation of neurovascular structures.
4. A physician performs an extensive surgical removal of a soft tissue tumor measuring 5.5cm in the knee area, with preparation of the excised tumor and surrounding tissue for pathology.
5. A surgeon excises a soft tissue tumor measuring 9cm in the thigh area, with irrigation of the patient’s wound and closure of the incision.
6. A patient undergoes surgery for the removal of a soft tissue tumor measuring 6.5cm in the knee area, with accurate documentation of the size and depth of the tumor and surrounding tissues.
7. A physician performs an extensive surgical removal of a soft tissue tumor measuring 7.5cm in the thigh area, with the involvement of a surgical assistant.
8. A surgeon excises a soft tissue tumor measuring 5.8cm in the knee area, with accurate documentation of the incision and dissection techniques.
9. A patient undergoes surgery for the removal of a soft tissue tumor measuring 8.2cm in the thigh area, with preservation of neurovascular structures and preparation of the excised tumor and surrounding tissue for pathology.
10. A physician performs an extensive surgical removal of a soft tissue tumor measuring 6.7cm in the knee area, with accurate documentation of the irrigation of the patient’s wound and closure of the incision.