How To Use CPT Code 27519

CPT 27519 describes the open treatment of distal femoral epiphyseal separation, including internal fixation, when performed. 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 27519?

CPT 27519 can be used to describe the open treatment of distal femoral epiphyseal separation, which involves the use of internal fixation to ensure proper alignment and stability of the fractured bone. This code is used when the provider performs a surgical procedure to fixate the distal femoral epiphysis using external devices.

2. Official Description

The official description of CPT code 27519 is: ‘Open treatment of distal femoral epiphyseal separation, includes internal fixation, when performed.’

3. Procedure

1. The provider begins by making an incision over the distal femoral condyle.
2. They then identify the fracture site and manually manipulate the fragments to align them in the correct anatomical position.
3. If necessary, the provider may apply internal fixation devices to stabilize the fracture and prevent further injury to the growth plate.
4. After ensuring hemostasis, the provider closes the incision with sutures in layers.

4. Qualifying circumstances

Patients eligible for CPT 27519 are those with a distal femoral epiphyseal separation that requires open treatment and internal fixation. This procedure is typically performed on young children who have experienced a fracture or separation of the growth plate in the distal femur. The provider must use internal fixation devices to stabilize the fracture and ensure proper healing.

5. When to use CPT code 27519

CPT code 27519 should be used when the provider performs an open treatment of distal femoral epiphyseal separation and includes internal fixation as part of the procedure. This code should not be used if the provider performs a closed reduction without manipulation or if skin or skeletal traction is used.

6. Documentation requirements

To support a claim for CPT 27519, the provider must document the following information:

• Patient’s diagnosis of distal femoral epiphyseal separation
• Description of the procedure performed, including the use of internal fixation
• Date of the procedure
• Details of the incision and closure
• Any additional procedures or services provided during the same encounter
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27519, ensure that the procedure meets the criteria for open treatment of distal femoral epiphyseal separation with internal fixation. It is important to follow the documentation requirements and provide accurate information on the claim form. Additionally, be aware of any specific billing guidelines or modifiers that may be required by payers.

8. Historical information

CPT 27519 was added to the Current Procedural Terminology system on January 1, 1990. There have been several historical changes to the code, including updates to the description and its inclusion on the Inpatient Only (IPO) list for Medicare. It is important to stay updated on any changes or revisions to ensure accurate coding and billing.

9. Examples

1. A surgeon performs an open treatment of distal femoral epiphyseal separation with internal fixation on a 10-year-old patient.
2. A pediatric orthopedic specialist performs an open reduction and internal fixation of a distal femoral epiphyseal separation in a 7-year-old patient.
3. A trauma surgeon performs an open treatment of distal femoral epiphyseal separation with internal fixation on a 5-year-old patient involved in a car accident.
4. An orthopedic surgeon performs an open reduction and internal fixation of a distal femoral epiphyseal separation in a 9-year-old patient with a sports-related injury.
5. A pediatric orthopedic specialist performs an open treatment of distal femoral epiphyseal separation with internal fixation on an 8-year-old patient with a congenital bone disorder.
6. A surgeon performs an open reduction and internal fixation of a distal femoral epiphyseal separation in a 6-year-old patient who fell from a tree.
7. An orthopedic surgeon performs an open treatment of distal femoral epiphyseal separation with internal fixation on a 12-year-old patient involved in a bicycle accident.
8. A trauma surgeon performs an open reduction and internal fixation of a distal femoral epiphyseal separation in an 11-year-old patient with a sports-related injury.
9. A pediatric orthopedic specialist performs an open treatment of distal femoral epiphyseal separation with internal fixation on a 9-year-old patient with a congenital bone disorder.
10. A surgeon performs an open reduction and internal fixation of a distal femoral epiphyseal separation in a 7-year-old patient who fell from a playground structure.