How To Use CPT Code 27808

CPT 27808 describes the closed treatment of a bimalleolar ankle fracture without manipulation. 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 27808?

CPT 27808 is used to describe the closed treatment of a bimalleolar ankle fracture without manipulation. This means that the provider fixes two of the broken malleoli bones of the ankle, either the lateral and medial malleoli, the lateral and posterior malleoli, or the medial and posterior malleoli, without the need for an open incision. This procedure is typically performed on stable fractures that do not require manipulation to realign the bones.

2. Official Description

The official description of CPT code 27808 is: ‘Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); without manipulation.’

3. Procedure

1. When performing CPT 27808, the provider first assesses the patient’s fractured malleoli bones, which include the medial (inner bone), lateral (outer bone), and posterior (rear bone) malleoli.
2. The provider then treats any two fractured malleoli out of the three by placing a cast on the ankle.
3. No reduction or adjustment is needed to realign the bones, so the provider proceeds with stabilizing the fracture and providing pain management instructions to the patient.
4. A cast, brace, or splint may be applied to support the healing process.
5. Post-treatment X-rays may be taken to ensure the correct alignment of the bones.

4. Qualifying circumstances

CPT 27808 is used for patients with a bimalleolar ankle fracture, which involves two of the three malleoli bones. The procedure is performed without manipulation, meaning that the bones do not need to be manually realigned. This code is used for stable fractures that can be treated with closed methods.

5. When to use CPT code 27808

CPT code 27808 should be used when a provider performs closed treatment of a bimalleolar ankle fracture without manipulation. It is important to note that this code should not be used if the procedure involves open treatment or if manipulation is required to realign the fractured bones.

6. Documentation requirements

To support a claim for CPT 27808, the provider must document the following information:

• Diagnosis of a bimalleolar ankle fracture
• Confirmation that the treatment was performed without manipulation
• Date of the procedure
• Details of the closed treatment, including the specific bones involved
• Any post-treatment X-rays taken to confirm correct alignment

7. Billing guidelines

When billing for CPT 27808, ensure that the procedure meets the criteria of closed treatment without manipulation for a bimalleolar ankle fracture. It is important to consider whether external or internal fixation was used, as the code may include reimbursement for fracture fixation. If external fixation is not part of the basic procedure, separate codes for external fixation should be used.

8. Historical information

CPT 27808 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2008, with the addition of the term “including Potts” to the description.

9. Examples

1. A patient presents with a fractured medial and lateral malleolus of the ankle. The provider performs closed treatment of the bimalleolar ankle fracture without manipulation, applying a cast for stabilization.
2. Another patient has a fractured lateral and posterior malleolus. The provider treats the bimalleolar ankle fracture with closed treatment, applying a brace to support healing.
3. A third patient has a fractured medial and posterior malleolus. The provider performs closed treatment of the bimalleolar ankle fracture without manipulation, applying a splint for support.
4. A fourth patient presents with a fractured medial and lateral malleolus, as well as a fractured posterior lip. The provider performs closed treatment of the bimalleolar ankle fracture without manipulation, applying a cast and providing pain management instructions.
5. Lastly, a patient has a fractured lateral and posterior malleolus, along with multiple fragments of the lateral malleolus. The provider performs closed treatment of the bimalleolar ankle fracture without manipulation, applying a cast and scheduling follow-up X-rays to monitor alignment.