How To Use CPT Code 27468

CPT 27468 describes a surgical procedure that involves the lengthening and shortening of the femur bone, along with the transfer of a femur segment. This article will provide an overview of CPT code 27468, 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 27468?

CPT 27468 is a code used to describe a surgical procedure that involves the lengthening and shortening of the femur bone, as well as the transfer of a femur segment. This procedure is typically performed to treat legs with unequal lengths, also known as leg length discrepancy (LLD). The provider surgically manipulates the femur bone to achieve the desired length and alignment.

2. Official Description

The official description of CPT code 27468 is: ‘Osteoplasty, femur; combined, lengthening and shortening with femoral segment transfer.’

3. Procedure

1. The provider begins by making an incision in the skin over the femur bone.
2. They then dissect through the subcutaneous tissue and incise the periosteum, being careful to protect the vascular and nervous tissue.
3. To shorten the femur length, the provider incises a segment of bone and brings the bone ends closer together.
4. For lengthening the bone, the provider incises the bone into upper and lower segments and introduces a new segment of bone that was saved from the shortening procedure.
5. The new segment is fixed in place between the cut bone using screws and plates.
6. The provider repairs the periosteum and soft tissue and closes the wound by suturing the skin.
7. Alternatively, an external fixator device may be used for bone lengthening, where pins or screws are inserted into the bone and an external fixator is attached to them.
8. The provider may apply traction to lengthen the bone or apply traction at a later encounter, depending on the fixator device used.
9. The external fixator device is eventually removed, and new bone develops in the gap created by the traction, a process known as distraction osteogenesis.

4. Qualifying circumstances

CPT 27468 is performed when there is a leg length discrepancy that requires surgical intervention. The procedure is typically reserved for cases where the difference in leg lengths is significant and affects the patient’s mobility and quality of life. The provider must carefully assess the patient’s condition and determine if the benefits of the procedure outweigh the potential risks and complications.

5. When to use CPT code 27468

CPT code 27468 should be used when a provider performs a combined lengthening and shortening procedure of the femur bone, along with the transfer of a femur segment. This code is appropriate for cases where there is a leg length discrepancy that requires surgical correction. It is important to note that CPT code 27468 should not be used for other types of femur osteoplasty procedures, such as shortening or lengthening alone.

6. Documentation requirements

To support a claim for CPT code 27468, the provider must document the following information:

• Patient’s diagnosis and the presence of leg length discrepancy
• Details of the surgical procedure performed, including the specific techniques used for lengthening, shortening, and femoral segment transfer
• Date of the procedure
• Any complications or unexpected findings during the procedure
• Post-operative care instructions and follow-up plans
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 27468, ensure that the procedure performed meets the criteria outlined in the code description. It is important to accurately document the lengthening, shortening, and femoral segment transfer procedures in the medical record to support the claim. Additionally, it is crucial to follow any specific billing guidelines provided by the payer to ensure proper reimbursement.

8. Historical information

CPT code 27468 was added to the Current Procedural Terminology system on January 1, 1990. It has undergone changes in its status as an inpatient-only (IPO) procedure, being removed from the IPO list in 2021 but added back in 2022.

9. Examples

1. A patient with a leg length discrepancy undergoes a combined lengthening and shortening procedure of the femur bone, along with the transfer of a femur segment, using CPT code 27468.
2. A provider performs a femur osteoplasty procedure for a patient with a significant leg length discrepancy, using CPT code 27468 to accurately report the combined lengthening and shortening with femoral segment transfer.
3. In a case of leg length discrepancy, a surgeon performs a surgical procedure involving the lengthening and shortening of the femur bone, along with the transfer of a femur segment, and reports CPT code 27468.
4. A patient with a leg length discrepancy undergoes a surgical procedure where the femur bone is manipulated to achieve the desired length and alignment, using CPT code 27468.
5. A provider performs a combined lengthening and shortening procedure of the femur bone, along with the transfer of a femur segment, for a patient with a leg length discrepancy, accurately reporting the procedure using CPT code 27468.
6. In a case of leg length discrepancy, a surgeon performs a surgical procedure involving the lengthening and shortening of the femur bone, along with the transfer of a femur segment, and appropriately bills CPT code 27468.
7. A patient with a significant leg length discrepancy undergoes a combined lengthening and shortening procedure of the femur bone, along with the transfer of a femur segment, using CPT code 27468 to accurately report the procedure.