How To Use CPT Code 27496

CPT 27496 describes the procedure of decompression fasciotomy in the thigh and/or knee to relieve pressure and increase blood flow. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 27496?

CPT 27496 is used to describe the procedure of decompression fasciotomy in the thigh and/or knee. This procedure involves cutting into the fascia of any one compartment in the thigh and/or knee to relieve pressure and increase blood flow. It is typically performed to treat conditions such as compartment syndrome, which is characterized by increased pressure in a muscle compartment leading to muscle and nerve damage and reduced blood flow.

2. Official Description

The official description of CPT code 27496 is: ‘Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor).’ This code specifically refers to the procedure of cutting into the fascia of one compartment in the thigh and/or knee to relieve pressure.

3. Procedure

1. The provider begins by assessing the patient’s condition and determining the need for decompression fasciotomy.
2. An incision is made in the skin overlying the affected area, providing access to the fascia above the targeted muscle compartment.
3. The provider cuts through the fascia, reducing the pressure on the neurovascular structures beneath it.
4. This procedure restores blood supply and relieves the patient from symptoms associated with compartment syndrome, such as decreased sensation, numbness, weakness, and severe pain.
5. At the end of the procedure, the provider may choose to leave the wound open or close it by suturing the soft tissues in layers.

4. Qualifying circumstances

CPT 27496 is performed on patients with compartment syndrome of the thigh or knee, where increased pressure in a muscle compartment leads to reduced blood flow and potential muscle and nerve damage. The procedure is specifically performed on one compartment, which can be the flexor, extensor, or adductor compartment. It is important to note that this code does not include debridement of nonviable muscle and/or nerve tissue.

5. When to use CPT code 27496

CPT code 27496 should be used when a provider performs decompression fasciotomy in one compartment of the thigh and/or knee without debridement of nonviable muscle and/or nerve tissue. It is important to accurately document the specific compartment targeted during the procedure.

6. Documentation requirements

To support a claim for CPT 27496, the provider must document the following information:

• Patient’s diagnosis and the need for decompression fasciotomy
• Specific compartment targeted during the procedure (flexor, extensor, or adductor)
• Date of the procedure
• Details of the procedure, including the incision and cutting through the fascia
• Any additional procedures performed, such as wound closure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27496, ensure that the procedure involves decompression fasciotomy in one compartment of the thigh and/or knee without debridement. It is important to accurately document the specific compartment targeted during the procedure. There are additional codes available if debridement or decompression fasciotomy of multiple compartments is performed. It is also important to follow any specific guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 27496 was added to the Current Procedural Terminology system on January 1, 1993. On January 1, 2010, the code description was changed to specify ‘one compartment’ instead of ‘any one compartment.’

9. Examples

1. A patient with compartment syndrome of the thigh undergoes decompression fasciotomy in the flexor compartment to relieve pressure and restore blood flow.
2. A provider performs decompression fasciotomy in the extensor compartment of the knee to alleviate symptoms of compartment syndrome.
3. During a surgical procedure, a surgeon performs decompression fasciotomy in the adductor compartment of the thigh to relieve pressure and improve blood flow.
4. A patient with compartment syndrome in the thigh undergoes decompression fasciotomy in the flexor compartment, resulting in symptom relief and improved blood circulation.
5. A provider performs decompression fasciotomy in the extensor compartment of the knee to alleviate pressure and restore normal blood flow in a patient with compartment syndrome.
6. During a surgical procedure, a surgeon performs decompression fasciotomy in the adductor compartment of the thigh to relieve pressure and restore blood flow in a patient with compartment syndrome.
7. A patient with compartment syndrome of the thigh undergoes decompression fasciotomy in the flexor compartment to alleviate symptoms and improve blood circulation.
8. A provider performs decompression fasciotomy in the extensor compartment of the knee to relieve pressure and restore normal blood flow in a patient with compartment syndrome.
9. During a surgical procedure, a surgeon performs decompression fasciotomy in the adductor compartment of the thigh to alleviate symptoms and improve blood circulation in a patient with compartment syndrome.
10. A patient with compartment syndrome of the thigh undergoes decompression fasciotomy in the flexor compartment to relieve pressure and restore blood flow.