How To Use CPT Code 27759

CPT 27759 describes the treatment of a tibial shaft fracture using an intramedullary implant, with or without interlocking screws and/or cerclage. 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 27759?

CPT 27759 can be used to describe the treatment of a tibial shaft fracture using an intramedullary implant. The procedure may involve the use of interlocking screws and/or cerclage to stabilize the fracture. It is important to note that this code does not include the treatment of a fibular fracture if present. The purpose of this procedure is to keep the fracture aligned and prevent displacement while promoting healing and relieving pain.

2. Official Description

The official description of CPT code 27759 is: ‘Treatment of tibial shaft fracture (with or without fibular fracture) by intramedullary implant, with or without interlocking screws and/or cerclage.’

3. Procedure

1. The provider begins by making an incision over the tibial shaft fracture.
2. Radiographic imaging is used to manipulate the fracture into the correct position.
3. A nail or rod is threaded down into the intramedullary canal of the bone and across the fracture site.
4. Interlocking screws may be placed at angles to the nail to further stabilize the fracture.
5. Cerclage, which involves encircling fracture fragments with wire, may also be performed.
6. The wound is thoroughly irrigated with an antibiotic solution to prevent infection, bleeding is controlled, and the incision is closed in layers.

4. Qualifying circumstances

CPT 27759 is used for the treatment of a tibial shaft fracture, with or without a fibular fracture, using an intramedullary implant. The procedure is performed to keep the fracture aligned, prevent displacement, promote healing, and relieve pain. It is important to note that the treatment of a fibular fracture should not be coded separately.

5. When to use CPT code 27759

CPT code 27759 should be used when a provider performs the treatment of a tibial shaft fracture using an intramedullary implant, with or without interlocking screws and/or cerclage. It is important to ensure that the procedure does not involve the treatment of a fibular fracture separately.

6. Documentation requirements

To support a claim for CPT 27759, the provider must document the following information:

• Type of fracture being treated (tibial shaft fracture with or without fibular fracture)
• Details of the procedure performed, including the use of an intramedullary implant, interlocking screws, and/or cerclage
• Date of the procedure
• Any additional procedures performed, if applicable
• Any complications or unexpected findings
• Signature of the provider

7. Billing guidelines

When billing for CPT 27759, ensure that the procedure meets the criteria described in the official description. It is important to note that the treatment of a fibular fracture should not be reported separately. Consider the global period and report any additional services or supplies separately. If external fixation is applied, use codes for external fixation when appropriate.

8. Historical information

CPT 27759 was added to the Current Procedural Terminology system on January 1, 1993, with a code change on January 1, 2003. The code has not been updated since its addition.

9. Examples

1. A provider performs the treatment of a tibial shaft fracture using an intramedullary implant, with interlocking screws, for a patient involved in a car accident.
2. A patient sustains a tibial shaft fracture while playing sports, and a provider performs the treatment using an intramedullary implant and cerclage.
3. A provider treats a tibial shaft fracture with an intramedullary implant and interlocking screws for a patient who fell from a height.
4. A patient presents with a tibial shaft fracture and a fibular fracture, and a provider performs the treatment using an intramedullary implant, without interlocking screws or cerclage.
5. A provider treats a tibial shaft fracture with an intramedullary implant and interlocking screws for a patient involved in a workplace accident.
6. A patient sustains a tibial shaft fracture during a sporting event, and a provider performs the treatment using an intramedullary implant and cerclage.
7. A provider treats a tibial shaft fracture with an intramedullary implant and interlocking screws for a patient who was in a motorcycle accident.
8. A patient presents with a tibial shaft fracture and a fibular fracture, and a provider performs the treatment using an intramedullary implant, without interlocking screws or cerclage.
9. A provider treats a tibial shaft fracture with an intramedullary implant and interlocking screws for a patient who fell on ice.
10. A patient sustains a tibial shaft fracture during a hiking trip, and a provider performs the treatment using an intramedullary implant and cerclage.