How To Use CPT Code 27734

CPT 27734 describes a surgical procedure known as arrest, epiphyseal (epiphysiodesis), open, specifically targeting the distal tibia and fibula. This article will provide an overview of the code, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of when CPT 27734 may be used.

1. What is CPT Code 27734?

CPT 27734 is a code used to describe a surgical procedure called arrest, epiphyseal (epiphysiodesis), open, which focuses on the distal tibia and fibula. This procedure involves fusing the end plates of the lower tibia and fibula to interrupt their growth. By doing so, the growth of these bones is stopped, ensuring that they do not grow longer than the other leg during the growth phase. The purpose of this procedure is to equalize the length of both legs as the patient continues to grow.

2. Official Description

The official description of CPT code 27734 is: ‘Arrest, epiphyseal (epiphysiodesis), open; distal tibia and fibula.’

3. Procedure

1. The procedure begins with the patient being appropriately prepped and anesthetized.
2. The provider makes an incision over the epiphyses of the distal tibia and distal fibula.
3. Through this incision, the provider reaches the bone and makes two through and through osteotomy type incisions.
4. A circular block is then removed from each bone.
5. The provider scrapes these blocks on one side to roughen the surface.
6. Each block is rotated upside down and placed back in its original position.
7. The blocks are fixed with pins to secure them in place.
8. The wound is thoroughly irrigated with an antibiotic solution to prevent infection.
9. Any bleeding is controlled, and the incision is closed in layers.

4. Qualifying circumstances

CPT 27734 is performed on patients who require equalization of leg length due to a growth discrepancy. This procedure is specifically targeted at the distal tibia and fibula. It is important to note that there are other codes available for different scenarios involving the tibia, fibula, and other bones in the leg.

5. When to use CPT code 27734

CPT code 27734 should be used when a provider performs an open epiphyseal arrest procedure on the distal tibia and fibula. It is important to ensure that the procedure is specifically focused on these bones and not other areas of the leg. Other codes should be used for different scenarios involving different bones in the leg.

6. Documentation requirements

When reporting CPT code 27734, the following documentation is required:

• Patient’s diagnosis and the need for the procedure
• Details of the procedure performed, including the specific bones targeted (distal tibia and fibula)
• Incision details, including the location and length
• Description of the osteotomy type incisions made
• Information on the circular blocks removed from each bone
• Details of how the blocks were rotated and fixed with pins
• Documentation of any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 27734, it is important to ensure that the procedure performed matches the description of the code. This code should not be reported for procedures involving different bones in the leg. It is also important to follow any specific billing guidelines provided by payers or coding guidelines. Modifier usage should be in accordance with payer requirements.

8. Historical information

CPT code 27734 was added to the Current Procedural Terminology system on January 1, 1990. There have been historical changes to the code, including a code change on January 1, 2003, which modified the description to specify ‘distal tibia and fibula’.

9. Examples

1. A patient with a growth discrepancy undergoes an open epiphyseal arrest procedure on the distal tibia and fibula to equalize leg length.
2. A provider performs an epiphyseal arrest procedure on the distal tibia and fibula of a pediatric patient with a congenital leg length discrepancy.
3. An adolescent patient with a growth discrepancy undergoes an open epiphyseal arrest procedure on the distal tibia and fibula to prevent further leg length discrepancy.
4. A provider performs an epiphyseal arrest procedure on the distal tibia and fibula of a patient with a leg length discrepancy resulting from a previous injury.
5. A pediatric patient with a growth discrepancy undergoes an open epiphyseal arrest procedure on the distal tibia and fibula to ensure proper leg alignment.
6. An adult patient with a growth discrepancy resulting from a previous injury undergoes an open epiphyseal arrest procedure on the distal tibia and fibula to prevent further complications.
7. A provider performs an epiphyseal arrest procedure on the distal tibia and fibula of a patient with a leg length discrepancy caused by a bone deformity.
8. A pediatric patient with a growth discrepancy undergoes an open epiphyseal arrest procedure on the distal tibia and fibula to improve overall leg function.
9. An adolescent patient with a growth discrepancy resulting from a previous injury undergoes an open epiphyseal arrest procedure on the distal tibia and fibula to prevent further complications.