How To Use CPT Code 27437

CPT 27437 describes the repair of a painful damaged knee cap without the insertion of an artificial knee joint prosthesis. 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 27437?

CPT 27437 is used to describe the repair of a painful damaged knee cap without the use of an artificial knee joint prosthesis. This procedure is performed by a healthcare provider to alleviate pain and improve the function of the knee cap. It involves making an incision over the affected knee cap, removing the knee cap, flattening the tibial and femoral ends, flushing the site with sterile saline, ensuring hemostasis, and closing the incision with sutures.

2. Official Description

The official description of CPT code 27437 is: ‘Arthroplasty, patella; without prosthesis.’

3. Procedure

1. The healthcare provider prepares and anesthetizes the patient.
2. An incision is made over the affected knee cap.
3. The knee cap is removed.
4. The tibial and femoral ends are flattened.
5. The site is flushed with sterile saline.
6. Hemostasis is ensured.
7. The incision is closed with sutures in layers.

4. Qualifying circumstances

CPT 27437 is performed on patients who have a painful damaged knee cap that requires repair. The procedure is appropriate for patients who do not need an artificial knee joint prosthesis. It is important to note that this code represents a unilateral service, meaning it is performed on one knee. If the provider performs the procedure on both knees, modifier 50 or the RT and LT modifiers should be appended based on payer preference.

5. When to use CPT code 27437

CPT code 27437 should be used when a healthcare provider performs the repair of a painful damaged knee cap without the use of an artificial knee joint prosthesis. It should not be used when an artificial knee joint prosthesis is inserted. It is important to review the full range of codes that apply when knee arthroplasty is performed to ensure accurate coding.

6. Documentation requirements

To support a claim for CPT 27437, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for knee cap repair
• Details of the procedure performed, including the incision, removal of the knee cap, flattening of the tibial and femoral ends, flushing of the site, and closure of the incision
• Date of the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 27437, ensure that the procedure is performed without the use of an artificial knee joint prosthesis. Modifier 50 or the RT and LT modifiers should be appended if the procedure is performed on both knees. It is important to review the full range of codes that apply when knee arthroplasty is performed to ensure accurate coding.

8. Historical information

CPT 27437 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider performs the repair of a painful damaged knee cap without the use of an artificial knee joint prosthesis for a patient with patellar instability.
2. A patient with a fractured knee cap undergoes the repair procedure without the insertion of an artificial knee joint prosthesis.
3. A healthcare provider performs the repair of a painful damaged knee cap without the use of an artificial knee joint prosthesis for a patient with patellofemoral pain syndrome.
4. A patient with a dislocated knee cap undergoes the repair procedure without the insertion of an artificial knee joint prosthesis.
5. A healthcare provider performs the repair of a painful damaged knee cap without the use of an artificial knee joint prosthesis for a patient with chondromalacia patellae.
6. A patient with a degenerative knee cap condition undergoes the repair procedure without the insertion of an artificial knee joint prosthesis.
7. A healthcare provider performs the repair of a painful damaged knee cap without the use of an artificial knee joint prosthesis for a patient with patellar tendinitis.
8. A patient with a dislocated knee cap undergoes the repair procedure without the insertion of an artificial knee joint prosthesis.
9. A healthcare provider performs the repair of a painful damaged knee cap without the use of an artificial knee joint prosthesis for a patient with patellar fracture.
10. A patient with a degenerative knee cap condition undergoes the repair procedure without the insertion of an artificial knee joint prosthesis.