How To Use CPT Code 27516

CPT 27516 describes the closed treatment of distal femoral epiphyseal separation without manipulation. 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 27516?

CPT 27516 is used to describe the closed treatment of distal femoral epiphyseal separation without manipulation. This code is used when the provider stabilizes and reduces the separation between the epiphysis, which is the lower end part of the femur, without making a surgical incision or using a traction device.

2. Official Description

The official description of CPT code 27516 is: ‘Closed treatment of distal femoral epiphyseal separation; without manipulation.’

3. Procedure

1. The provider begins by assessing the fracture and obtaining X-rays to evaluate the extent of the separation.
2. Once the patient is appropriately prepped and anesthetized, the provider applies a hip cast at the site of the fracture to achieve stabilization.
3. The cast keeps the leg straight and immobilized, allowing the fracture to heal.
4. After three to four weeks, the provider removes the cast to ensure proper fixation of the fracture.

4. Qualifying circumstances

CPT 27516 is used for patients who have a distal femoral epiphyseal separation that requires closed treatment without manipulation. This code is applicable when the provider stabilizes the fracture without making a surgical incision or using a traction device. It is important to note that this code should not be used if manipulation or open reduction and internal fixation are performed.

5. When to use CPT code 27516

CPT code 27516 should be used when the provider performs closed treatment of a distal femoral epiphyseal separation without manipulation. This code is appropriate when the provider stabilizes and reduces the separation using a hip cast, without making a surgical incision or using a traction device.

6. Documentation requirements

To support a claim for CPT 27516, the provider must document the following information:

• Patient’s diagnosis of distal femoral epiphyseal separation
• Description of the closed treatment procedure performed
• Date of the procedure
• Start and end time of the procedure
• Details of any additional supplies used, such as casting materials
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27516, ensure that the procedure performed meets the criteria for closed treatment of distal femoral epiphyseal separation without manipulation. This code should not be reported if manipulation or open reduction and internal fixation are performed. Additionally, consider reporting any additional supplies used during the procedure using the appropriate HCPCS codes.

8. Historical information

CPT 27516 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 provider performs closed treatment of a distal femoral epiphyseal separation without manipulation for a young child who sustained the injury during a fall.
2. A patient presents with a distal femoral epiphyseal separation, and the provider applies a hip cast to stabilize the fracture without performing any manipulation.
3. A teenager is brought to the emergency room with a distal femoral epiphyseal separation, and the provider performs closed treatment by applying a hip cast.
4. A provider treats a distal femoral epiphyseal separation in a young athlete without manipulation, using a hip cast to stabilize the fracture and promote healing.
5. A child is diagnosed with a distal femoral epiphyseal separation, and the provider performs closed treatment by applying a hip cast without any manipulation of the fracture.
6. A provider applies a hip cast to stabilize a distal femoral epiphyseal separation in a young patient, ensuring proper alignment and healing without manipulation.
7. A teenager sustains a distal femoral epiphyseal separation, and the provider performs closed treatment by applying a hip cast without any manipulation.
8. A provider treats a distal femoral epiphyseal separation in a child without manipulation, using a hip cast to stabilize the fracture and facilitate healing.
9. A young patient presents with a distal femoral epiphyseal separation, and the provider applies a hip cast to stabilize the fracture without performing any manipulation.
10. A provider performs closed treatment of a distal femoral epiphyseal separation without manipulation for a child who fell from a height.