How To Use CPT Code 27558

CPT 27558 describes the open treatment of knee dislocation, including internal fixation, when performed, with primary ligamentous repair, with augmentation/reconstruction. 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 27558?

CPT 27558 can be used to describe the open treatment of knee dislocation, which involves the repair of the primary ligament and the use of internal fixation, such as pins or screws, to stabilize the knee. This code is used when the provider performs a ligamentous repair with augmentation or reconstruction during the procedure.

2. Official Description

The official description of CPT code 27558 is: ‘Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair, with augmentation/reconstruction.’

3. Procedure

1. The provider begins by making an anterior midline incision and prepares the patient for the procedure.
2. Loose fragments are debrided, and the provider manipulates the knee to return it to the correct anatomical position.
3. Internal fixation devices, such as pins or screws, are applied to achieve stability and prevent future dislocation.
4. The provider repairs the primary ligament, such as the anterior cruciate or posterior cruciate ligament, by making a passage in the tibia and femur and inserting a graft through the passage.
5. Hemostasis is ensured, and the incision is closed with sutures in layers.

4. Qualifying circumstances

CPT 27558 is used for patients who require open treatment of knee dislocation with primary ligamentous repair and augmentation or reconstruction. This procedure is performed by a qualified provider and involves the use of internal fixation devices to stabilize the knee. The ligament repair is typically performed on ligaments such as the anterior cruciate or posterior cruciate ligament.

5. When to use CPT code 27558

CPT code 27558 should be used when the provider performs an open treatment of knee dislocation with primary ligamentous repair and augmentation or reconstruction. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 27558, the provider must document the following information:

• Patient’s diagnosis and the need for open treatment of knee dislocation
• Details of the procedure, including the use of internal fixation devices and ligament repair
• Date of the procedure
• Any additional procedures or techniques performed
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27558, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the details of the procedure and any additional services provided. Be aware of any bundling or unbundling issues and follow the appropriate coding guidelines.

8. Historical information

CPT 27558 was added to the Current Procedural Terminology system on January 1, 1993. There have been several historical changes to the code, including updates to the code description and its inclusion on the Inpatient Only (IPO) list for Medicare. It is important to stay updated on any changes or revisions to the code.

9. Examples

1. A provider performs an open treatment of knee dislocation with primary ligamentous repair and augmentation for a patient who suffered a sports-related injury.
2. A patient with a severe knee dislocation undergoes open treatment with internal fixation and ligament repair to restore stability and function.
3. A provider performs an open reduction and internal fixation with ligamentous repair for a patient who experienced a traumatic knee dislocation in a car accident.
4. An athlete with a chronic knee dislocation undergoes open treatment with primary ligamentous repair and augmentation to improve stability and prevent future dislocations.
5. A provider performs an open treatment of knee dislocation with primary ligamentous repair and reconstruction for a patient with a history of recurrent dislocations.
6. A patient with a complex knee dislocation undergoes open treatment with internal fixation and ligament repair to restore normal knee function.
7. A provider performs an open reduction and internal fixation with ligamentous repair and augmentation for a patient with a chronic knee dislocation due to a congenital condition.
8. An individual with a traumatic knee dislocation undergoes open treatment with primary ligamentous repair and augmentation to restore stability and prevent future dislocations.
9. A provider performs an open treatment of knee dislocation with primary ligamentous repair and reconstruction for a patient with a history of failed conservative treatments.
10. A patient with a severe knee dislocation undergoes open treatment with internal fixation and ligament repair to improve knee stability and prevent further damage.