How To Use CPT Code 27720

CPT 27720 describes the repair of a nonunion or malunion of the tibia without the use of a graft. 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 27720?

CPT 27720 can be used to describe the repair of a nonunion or malunion of the tibia without the use of a graft. This code is used when the provider needs to restore function and relieve pain in a patient whose fracture of the tibia has healed improperly or not at all.

2. Official Description

The official description of CPT code 27720 is: ‘Repair of nonunion or malunion, tibia; without graft, (eg, compression technique)’

3. Procedure

1. The provider begins by making an incision in the skin over the old fracture site and exposing the tibia.
2. Next, the provider debrides any fibrous tissue present in the area.
3. In cases of malunion, the provider may perform an osteotomy to obtain healthy, bleeding bone for the union.
4. The provider then holds the two ends of the fracture fragments together and secures them in place with a plate and screws.
5. Any bleeding is controlled, and the wound is closed in layers.

4. Qualifying circumstances

CPT 27720 is used when the patient has a nonunion or malunion of the tibia, which means that the fractured bone has not healed properly or has healed in an abnormal position. The procedure is performed to restore function and relieve pain in the patient. It does not involve the use of a graft.

5. When to use CPT code 27720

CPT code 27720 should be used when the provider is repairing a nonunion or malunion of the tibia without the use of a graft. It is important to note that this code should not be used for procedures involving a sliding graft or iliac or other autograft, as there are separate codes for those situations.

6. Documentation requirements

To support a claim for CPT 27720, the provider must document the following information:

• Patient’s diagnosis of nonunion or malunion of the tibia
• Description of the procedure performed, including any osteotomy if applicable
• Date of the procedure
• Details of the incision and closure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 27720, ensure that the procedure performed meets the criteria for nonunion or malunion repair of the tibia without a graft. It is important to note that modifier 62 should be appended if the provider is acting as a cosurgeon with another provider. Medicare and most other payers reimburse procedures coded with modifier 62 at 125 percent of the regular fee schedule amount.

8. Historical information

CPT 27720 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 presents with a nonunion of the tibia following a previous fracture. The provider performs a repair of the nonunion without the use of a graft.
2. A patient has a malunion of the tibia, resulting in pain and limited function. The provider performs a repair of the malunion without the use of a graft to restore function and relieve pain.
3. A patient’s tibia fracture has not healed properly, leading to a nonunion. The provider performs a repair of the nonunion without the use of a graft to promote proper healing.
4. A patient’s tibia fracture has healed in an abnormal position, causing pain and difficulty in walking. The provider performs a repair of the malunion without the use of a graft to correct the alignment and improve function.
5. A patient’s tibia fracture has not healed properly, resulting in a nonunion. The provider performs a repair of the nonunion without the use of a graft to promote bone healing and alleviate pain.