How To Use CPT Code 27524

CPT 27524 describes the open treatment of a patellar fracture, which involves the use of internal fixation and/or partial or complete patellectomy and soft tissue repair. 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 27524?

CPT 27524 is used to describe the open treatment of a patellar fracture. This procedure involves the provider performing an open reduction and internal fixation of the fractured knee cap, along with partial or complete excision of the patella and soft tissue repair. The goal of this procedure is to ensure stability of the patella and promote healing.

2. Official Description

The official description of CPT code 27524 is: ‘Open treatment of patellar fracture, with internal fixation and/or partial or complete patellectomy and soft tissue repair.’

3. Procedure

1. The provider begins by making a transverse incision along the line of fracture after the patient is appropriately prepped and anesthetized.
2. Loose bodies from and around the knee are debrided by the provider.
3. The provider then manipulates the fracture and applies internal fixation devices, such as K wires or screws, to align the bones in the correct anatomical position.
4. If the fracture is comminuted, the provider may partially or completely remove the patella.
5. Hemostasis is ensured, and the incision is closed with sutures in layers.

4. Qualifying circumstances

CPT 27524 is performed on patients with a patellar fracture that requires open treatment. The procedure is typically performed by a provider who is skilled in orthopedic surgery. The decision to perform this procedure is based on the patient’s specific condition and the provider’s clinical judgment.

5. When to use CPT code 27524

CPT code 27524 should be used when the provider performs an open treatment of a patellar fracture with internal fixation and/or partial or complete patellectomy and soft tissue repair. It is important to accurately document the details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT 27524, the provider must document the following information:

• Patient’s diagnosis of a patellar fracture
• Details of the procedure, including the use of internal fixation and/or partial or complete patellectomy
• Specific soft tissue repair techniques used
• Date of the procedure
• Any additional procedures or services performed during the same encounter
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27524, it is important to ensure that the documentation supports the use of this code. The procedure should be performed by a provider skilled in orthopedic surgery. It is also important to follow any specific billing guidelines provided by the payer. Modifier 57 may be used to indicate that the procedure was planned and not an emergency. Modifier 25 may be used if a separate, significant evaluation and management service was provided on the same day as the procedure.

8. Historical information

CPT 27524 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 patient sustains a patellar fracture and undergoes open treatment with internal fixation and soft tissue repair.
2. A provider performs an open reduction and internal fixation of a comminuted patellar fracture, along with partial patellectomy and soft tissue repair.
3. A patient with a patellar fracture undergoes open treatment with complete patellectomy and soft tissue repair.
4. A provider performs an open treatment of a patellar fracture with internal fixation and partial patellectomy, along with extensive soft tissue repair.
5. A patient presents with a patellar fracture and undergoes open treatment with internal fixation and soft tissue repair, as well as additional procedures to address associated injuries.