How To Use CPT Code 27725

CPT 27725 describes the repair of a nonunion or malunion of the tibia by synostosis, with the assistance of the fibula, using any method. 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 27725?

CPT 27725 is used to describe the surgical repair of a tibial fracture that has failed to heal or has healed with poor alignment. The procedure involves fusing the tibia with the assistance of the fibula. This code encompasses various methods that can be used to achieve the synostosis, or fusion, of the bones.

2. Official Description

The official description of CPT code 27725 is: ‘Repair of nonunion or malunion, tibia; by synostosis, with fibula, any method.’

3. Procedure

1. The surgeon begins by making an incision and dissecting through the subcutaneous tissues to expose the nonunion or malunion of the tibia.
2. If the fragments have failed to join, the surgeon decorticates the ends of both tibial fragments to create a bleeding bone, which promotes healing.
3. If the bones have healed in malalignment, the surgeon refractures the bones and freshens the ends.
4. The surgeon then aligns the tibial fragments anatomically and secures the tibia to the fibula using a plate, wires, or screws to maintain fixation.
5. The wound is thoroughly irrigated with an antibiotic solution to prevent infection, any bleeding is controlled, and the incision is closed in layers.

4. Qualifying circumstances

CPT 27725 is performed when a tibial fracture has failed to heal properly or has healed in an abnormal position. The procedure is indicated for patients who require the fusion of the tibia with the assistance of the fibula. The surgeon must assess the patient’s condition and determine the need for the repair.

5. When to use CPT code 27725

CPT code 27725 should be used when a surgeon performs the repair of a nonunion or malunion of the tibia by synostosis, with the assistance of the fibula, using any method. 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 27725, the surgeon must document the following information:

• Patient’s diagnosis of nonunion or malunion of the tibia
• Description of the specific method used for the synostosis
• Date of the procedure
• Details of the surgical technique, including any refracturing or decortication performed
• Method of fixation used to secure the tibia to the fibula
• Any additional procedures performed during the same surgical session
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT 27725, ensure that the procedure meets the criteria outlined in the code description. It is important to accurately document the surgical technique and any additional procedures performed. Modifier 62, Two surgeons, may be appended if the surgeon is acting as a cosurgeon with another provider. However, it is crucial to follow the specific guidelines and requirements set forth by the payer.

8. Historical information

CPT 27725 was added to the Current Procedural Terminology system on January 1, 1990. It was initially included in the Inpatient Only (IPO) list in 2017, but was later removed in 2021. However, as of 2022, it has been added back to the Inpatient Only (IPO) list.

9. Examples

1. A surgeon performs the repair of a nonunion of the tibia by synostosis, with the assistance of the fibula, using a plate fixation method.
2. Using a different surgical technique, a surgeon corrects a malunion of the tibia by refracturing the bones and securing them with screws.
3. Another surgeon performs the repair of a nonunion of the tibia by synostosis, with the assistance of the fibula, using a combination of plate and wire fixation.
4. Using a different method, a surgeon fuses the tibia with the assistance of the fibula using an intramedullary nail.
5. A surgeon repairs a malunion of the tibia by synostosis, with the assistance of the fibula, using an external fixator.
6. Using a different approach, a surgeon corrects a nonunion of the tibia by synostosis, with the assistance of the fibula, using an intramedullary rod.
7. Another surgeon performs the repair of a malunion of the tibia by synostosis, with the assistance of the fibula, using a combination of plate and screw fixation.
8. Using a different technique, a surgeon fuses the tibia with the assistance of the fibula using an external fixator and bone graft.
9. A surgeon repairs a nonunion of the tibia by synostosis, with the assistance of the fibula, using an intramedullary nail and bone graft.
10. Using a different method, a surgeon corrects a malunion of the tibia by refracturing the bones and securing them with a combination of plate and wire fixation.