How To Use CPT Code 27870

CPT 27870 describes a specific procedure known as ankle arthrodesis, which involves permanently fusing the ankle joint to alleviate pain and disability caused by severe arthritis. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 27870?

CPT 27870 is a code used to describe the surgical procedure of ankle arthrodesis. This procedure involves permanently joining the ankle joint to relieve pain and disability caused by severe arthritis. It is typically performed by a qualified healthcare professional who makes incisions on the outside and front of the ankle, removes the articular cartilage surfaces of the joint, prepares the underlying bone, and positions the joint in a specific alignment. The procedure may also involve the use of bone grafts, fixation devices, and other techniques to ensure the fusion of the joint.

2. Official Description

The official description of CPT code 27870 is: ‘Arthrodesis, ankle, open.’ This code specifically refers to the open surgical approach for ankle arthrodesis. It is important to note that for arthroscopic ankle arthrodesis, a different code, 29899, should be used.

3. Procedure

1. The healthcare professional begins by appropriately prepping and anesthetizing the patient.
2. Incisions are made on the outside and front of the ankle to access the joint.
3. The articular cartilage surfaces of the ankle joint are removed.
4. The underlying bone is prepared using a combination of instruments to create fresh bony surfaces.
5. The joint is positioned in neutral dorsiflexion and slight hind foot valgus to allow optimal motion through the surrounding joints.
6. In some cases, a portion of the fibula may be excised and repositioned to be included in the fusion mass.
7. Bone grafts may be used to augment the ankle fusion, typically taken from just below the knee or the pelvis.
8. Internal fixation devices, such as plates and screws, may be applied to stabilize the joint.
9. In some cases, an external fixation device may be used instead.
10. The area is irrigated, checked for bleeding, instruments are removed, and the incisions are closed.

4. Qualifying circumstances

Ankle arthrodesis using CPT code 27870 is typically performed on patients who have severe arthritis in the ankle joint. This condition causes pain, swelling, and limitation of movement. The procedure is considered when conservative treatments have failed to provide relief, and the patient’s quality of life is significantly affected. It is important to note that the procedure should be performed by a qualified healthcare professional with the necessary expertise in ankle arthrodesis.

5. When to use CPT code 27870

CPT code 27870 should be used when an open surgical approach is employed for ankle arthrodesis. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If the procedure is performed arthroscopically, a different code, 29899, should be used instead.

6. Documentation requirements

To support a claim for CPT code 27870, the healthcare professional must document the following information:

• Patient’s diagnosis of severe arthritis in the ankle joint
• Details of the surgical procedure, including the specific techniques used
• Date of the procedure
• Any additional procedures performed, such as bone grafting or the use of fixation devices
• Any complications or unexpected findings during the procedure
• Post-operative care instructions and follow-up plans
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 27870, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The use of appropriate modifiers may be necessary to indicate any additional procedures or services provided during the same encounter. It is also important to follow the guidelines set forth by the payer and to verify the medical necessity of the procedure.

8. Historical information

CPT code 27870 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 “ankle, any method.”

9. Examples

1. A patient with severe arthritis in the ankle joint undergoes ankle arthrodesis using an open surgical approach.
2. A healthcare professional performs ankle arthrodesis on a patient who has failed conservative treatments for ankle arthritis.
3. An individual with significant pain and disability in the ankle joint undergoes ankle arthrodesis to improve their quality of life.
4. A qualified healthcare professional fuses the ankle joint of a patient with severe arthritis, using bone grafts to augment the fusion.
5. Ankle arthrodesis is performed on a patient with severe ankle arthritis, utilizing internal fixation devices for stabilization.
6. A healthcare professional performs ankle arthrodesis on a patient who has exhausted all non-surgical treatment options for their ankle arthritis.
7. An individual with severe ankle arthritis undergoes ankle arthrodesis to alleviate pain and improve joint function.
8. A qualified healthcare professional performs ankle arthrodesis on a patient with severe ankle arthritis, using an external fixation device for stabilization.
9. Ankle arthrodesis is performed on a patient with severe arthritis, involving the removal of articular cartilage and fusion of the ankle joint.