How To Use CPT Code 27557

CPT 27557 describes the open treatment of knee dislocation, including internal fixation and primary ligamentous 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 27557?

CPT 27557 can be used to describe the open treatment of knee dislocation, which involves the correction of a dislocated knee through an anterior midline incision. The procedure includes internal fixation, such as the use of pins or screws, to stabilize the knee, as well as primary ligamentous repair.

2. Official Description

The official description of CPT code 27557 is: ‘Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair.’

3. Procedure

1. The provider begins by making an anterior midline incision and preparing the patient for the procedure.
2. Loose fragments around the dislocated knee are debrided, and the provider manually manipulates the knee to return it to its correct anatomical position.
3. Internal fixation devices, such as pins or screws, are used to maintain stability and prevent future dislocations.
4. The provider also performs primary ligamentous repair by reconnecting the torn ends using internal fixation devices, such as plates or screws.
5. Hemostasis is ensured, and the incision is closed with sutures in layers.

4. Qualifying circumstances

CPT 27557 is used for patients who require open treatment of knee dislocation with internal fixation and primary ligamentous repair. This procedure is typically performed when the knee has been dislocated and requires surgical intervention to restore normal anatomy and stability. The provider must perform both internal fixation and primary ligamentous repair to report this code.

5. When to use CPT code 27557

CPT code 27557 should be used when the provider performs open treatment of knee dislocation, including internal fixation and primary ligamentous repair. It is important to note that this code should not be used if the provider performs closed reduction or if the primary ligamentous repair is not performed.

6. Documentation requirements

To support a claim for CPT 27557, the provider must document the following information:

• Patient’s diagnosis of knee dislocation and the need for open treatment
• Description of the procedure performed, including the use of internal fixation and primary ligamentous repair
• Date of the procedure
• Details of the incision, debridement, reduction, and fixation techniques used
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 27557, ensure that the procedure meets the criteria for open treatment of knee dislocation with internal fixation and primary ligamentous repair. It is important to accurately document the procedure and any additional services provided. CPT code 27557 should not be reported with codes 27550 to 27556, as these codes represent different procedures for knee dislocation.

8. Historical information

CPT 27557 was added to the Current Procedural Terminology system on January 1, 1990. It underwent a code change on January 1, 2008, which expanded the description to include dislocation with or without internal or external fixation. Medicare made changes to its coverage of CPT 27557, adding it to the Inpatient Only (IPO) list in 2017, removing it from the IPO list in 2021, and adding it back to the IPO list in 2022.

9. Examples

1. A patient undergoes open treatment of knee dislocation with internal fixation and primary ligamentous repair following a sports injury.
2. A provider performs open reduction and internal fixation of knee dislocation with primary ligament repair in a patient involved in a motor vehicle accident.
3. An individual with a history of recurrent knee dislocations undergoes open treatment with internal fixation and primary ligamentous repair to stabilize the knee joint.
4. A patient with a complex knee dislocation undergoes open treatment with internal fixation and primary ligamentous repair to restore stability and function.
5. A provider performs open treatment of knee dislocation with internal fixation and primary ligamentous repair in a patient with a congenital knee joint abnormality.
6. An athlete with a severe knee dislocation undergoes open treatment with internal fixation and primary ligamentous repair to enable a return to sports activities.
7. A provider performs open reduction and internal fixation of knee dislocation with primary ligament repair in a patient with a history of chronic knee instability.
8. An individual with a traumatic knee dislocation undergoes open treatment with internal fixation and primary ligamentous repair to prevent recurrent dislocations.
9. A patient with a knee dislocation resulting from a fall undergoes open treatment with internal fixation and primary ligamentous repair to restore joint stability.
10. A provider performs open reduction and internal fixation of knee dislocation with primary ligament repair in a patient with a history of ligamentous laxity.