How To Use CPT Code 27640

CPT 27640 describes the partial excision of the tibia to treat osteomyelitis. 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 27640?

CPT 27640 is used to describe the partial excision of the tibia to treat osteomyelitis. This procedure involves the removal of a diseased portion of the bone, either by scooping out the bone or creating a saucer-like depression. It is important to note that this code should not be used for exostosis excision, which has its own specific code (CPT 27635).

2. Official Description

The official description of CPT code 27640 is: ‘Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); tibia.’ This code was added to the Current Procedural Terminology system on January 1, 1990, and there have been no updates to the code since its addition.

3. Procedure

1. The procedure begins with the patient being appropriately prepped and anesthetized.
2. The provider makes an incision in the skin of the tibia over the diseased portion of the bone.
3. He dissects down through the subcutaneous tissue and muscle.
4. All soft tissue layers are retracted, and the periosteum, the outer membrane of the bone, is incised and reflected.
5. The provider identifies the diseased portion of the bone.
6. If performing a craterization or saucerization, he removes the diseased bone with a burr, a motorized cutting device.
7. Depending on the amount of bone removed, a saucer-like or crater-like depression may be left in the bone, which can be filled with healthy bone.
8. If performing a diaphysectomy, the provider cuts completely through the bone and removes the diseased segment.
9. Again, depending on the amount of bone removed, the space may be filled with healthy bone.
10. The area is thoroughly washed with an antibiotic solution, and antibiotic beads may be placed in the excised bone area.
11. Any bleeding is controlled, and the wound is closed by suturing the soft tissue layers and closing the incision.

4. Qualifying circumstances

CPT 27640 is used for the treatment of osteomyelitis in the tibia. Osteomyelitis is an infection in the bone. The procedure is performed by a provider who removes a part of the diseased portion of the tibia, either by creating a saucer-like depression or by scooping out the bone. It is important to note that this code should not be used for exostosis excision, which has its own specific code (CPT 27635).

5. When to use CPT code 27640

CPT code 27640 should be used when a provider performs a partial excision of the tibia to treat osteomyelitis. It is important to ensure that the procedure is not an exostosis excision, as that has its own specific code (CPT 27635).

6. Documentation requirements

To support a claim for CPT code 27640, the provider must document the following information:

• Patient’s diagnosis of osteomyelitis
• Specific details of the procedure performed, including whether it was a craterization, saucerization, or diaphysectomy
• Location of the incision and the extent of the excision
• Any additional procedures performed, such as filling the excised area with healthy bone or placing antibiotic beads
• Details of the closure, including the type of sutures used
• Any complications or unexpected findings during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 27640, it is important to ensure that the procedure is not an exostosis excision, as that has its own specific code (CPT 27635). There are no specific billing guidelines mentioned for this code.

8. Historical information

CPT code 27640 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 provider performs a partial excision of the tibia to treat osteomyelitis in a patient.
2. During the procedure, the provider creates a saucer-like depression in the bone to remove the diseased portion.
3. Another provider performs a diaphysectomy, cutting completely through the bone and removing the diseased segment.
4. In a different case, the provider fills the excised area with healthy bone to promote healing.
5. During the procedure, the provider places antibiotic beads in the area where the bone was excised.
6. A provider performs a partial excision of the tibia to treat osteomyelitis, using a burr to remove the diseased bone.
7. In a complex case, the provider performs a partial excision of the tibia and also harvests a bone graft to fill the excised area.
8. During the procedure, the provider identifies unexpected findings and adjusts the extent of the excision accordingly.
9. A provider performs a partial excision of the tibia to treat osteomyelitis, using a curet to scrape out the diseased bone.