How To Use CPT Code 27647

CPT 27647 describes the radical resection of a tumor in either the talus or calcaneus. 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 27647?

CPT 27647 is used to describe the surgical procedure of removing a tumor from either the talus or calcaneus. This code is specifically used for cases where the tumor removal requires wide margins of normal tissue to be excised along with the tumor. The procedure is typically performed to treat severe chronic osteomyelitis or bone cancer in these areas.

2. Official Description

The official description of CPT code 27647 is: ‘Radical resection of tumor; talus or calcaneus.’

3. Procedure

1. The surgeon begins by making an incision in the skin over the affected area of the talus or calcaneus.
2. They then carefully dissect through the subcutaneous tissue and muscle to expose the bone.
3. The periosteum, the outer membrane of the bone, is incised and reflected to gain access to the tumor.
4. The surgeon identifies the tumor within the bone and proceeds to remove it along with a wide margin of healthy bone tissue.
5. If necessary, the cavity left by the excision may be filled with a bone graft.
6. The area is thoroughly washed with an antibiotic solution, and antibiotic beads may be placed in the excised bone area.
7. The periosteum is replaced over the area, and any bleeding is controlled.
8. The wound is closed by suturing the soft tissue layers and then closing the incision in layers.

4. Qualifying circumstances

CPT 27647 is performed in cases where there is a tumor in either the talus or calcaneus that requires radical resection. The procedure is typically indicated for severe chronic osteomyelitis or bone cancer. It is important to note that this code is specific to the talus or calcaneus and should not be used for tumors in other bones.

5. When to use CPT code 27647

CPT code 27647 should be used when a surgeon performs a radical resection of a tumor in either the talus or calcaneus, along with wide margins of healthy bone tissue. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If the tumor is located in a different bone, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 27647, the surgeon must document the following information:

• Patient’s diagnosis necessitating the radical resection of the tumor
• Details of the procedure, including the specific bone (talus or calcaneus) and the extent of the resection
• Use of a bone graft, if applicable
• Administration of antibiotic solution and placement of antibiotic beads, if performed
• Closure technique used for the wound
• Any additional relevant details or complications encountered during the procedure

7. Billing guidelines

When billing for CPT 27647, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The surgeon should use this code only for radical resection of a tumor in either the talus or calcaneus. It should not be reported for tumors in other bones. Additionally, any bone graft harvesting should be reported separately using the appropriate codes. It is important to follow the specific guidelines provided by the payer when submitting claims for CPT 27647.

8. Historical information

CPT 27647 was added to the Current Procedural Terminology system on January 1, 1990. The code description was updated on January 1, 2010 to clarify the specific bone locations (talus or calcaneus) for the procedure.

9. Examples

1. A surgeon performs a radical resection of a tumor in the talus of a patient with severe chronic osteomyelitis.
2. A patient with bone cancer in the calcaneus undergoes a radical resection of the tumor to remove it along with wide margins of healthy bone tissue.
3. A surgeon performs a radical resection of a tumor in the talus of a patient with bone cancer, using a bone graft to fill the excised cavity.
4. A patient with severe chronic osteomyelitis in the calcaneus undergoes a radical resection of the tumor, with subsequent placement of antibiotic beads in the excised bone area.
5. A surgeon performs a radical resection of a tumor in the talus of a patient, closing the wound using a complex closure technique due to the size and location of the excision.
6. A patient with bone cancer in the calcaneus undergoes a radical resection of the tumor, with subsequent referral for adjuvant therapy.
7. A surgeon performs a radical resection of a tumor in the talus of a patient, encountering complications during the procedure that require additional measures to control bleeding.
8. A patient with severe chronic osteomyelitis in the calcaneus undergoes a radical resection of the tumor, with subsequent referral for reconstructive surgery to restore function.
9. A surgeon performs a radical resection of a tumor in the talus of a patient, documenting the use of a bone graft harvested from the patient’s iliac crest.
10. A patient with bone cancer in the calcaneus undergoes a radical resection of the tumor, with subsequent placement of antibiotic beads and a complex closure technique due to the extent of the excision.