How To Use CPT Code 27881

CPT 27881 describes the procedure of amputation of the leg through the tibia and fibula, with immediate fitting technique including the application of the first cast. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 27881?

CPT 27881 is used to describe the surgical procedure of amputating the leg below the knee through the tibia and fibula. This procedure is performed to relieve pain or remove nonhealing tissue in the presence of poor vascular supply. The remaining skin flaps are closed, and a cast is applied to allow for immediate fitting of a prosthesis.

2. Official Description

The official description of CPT code 27881 is: ‘Amputation, leg, through tibia and fibula; with immediate fitting technique including application of first cast.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. A sterile tourniquet is applied to stop blood flow to the leg.
3. An incision is made and deepened through the subcutaneous tissues and muscles.
4. The major blood vessels in the calf are ligated, or tied off.
5. The tibia and fibula are transected using a power saw, with the fibula cut slightly higher to recess it away from the end of the stump.
6. The soft tissues are transected using an amputation knife.
7. The skin flaps are trimmed and closed over the stump.
8. A cast is applied over the stump to prepare it for a prosthesis.

4. Qualifying circumstances

CPT 27881 is performed when there is a need to amputate the leg below the knee through the tibia and fibula. This procedure is indicated for patients experiencing pain or nonhealing tissue in the presence of poor vascular supply. It is important to note that this procedure should only be performed by a qualified healthcare professional.

5. When to use CPT code 27881

CPT code 27881 should be used when performing an amputation of the leg through the tibia and fibula, with immediate fitting technique including the application of the first cast. 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 27881, the healthcare professional must document the following information:

• Patient’s diagnosis and the need for the amputation procedure
• Details of the procedure performed, including the specific techniques used
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 27881, ensure that the procedure meets the specific criteria outlined in the code description. It is important to follow the appropriate coding guidelines and modifiers, if applicable. Additionally, be aware of any specific billing requirements from insurance providers or government payers.

8. Historical information

CPT 27881 was added to the Current Procedural Terminology system on January 1, 1990. It has undergone changes in its status as an inpatient-only procedure, being removed from the list in 2021 and added back in 2022.

9. Examples

1. A patient with severe peripheral vascular disease undergoes an amputation of the leg through the tibia and fibula, with immediate fitting technique including the application of the first cast.
2. An individual with a nonhealing wound in the lower leg undergoes an amputation through the tibia and fibula, with immediate fitting technique including the application of the first cast.
3. A patient with a traumatic injury to the lower leg requires an amputation through the tibia and fibula, with immediate fitting technique including the application of the first cast.
4. An individual with a bone tumor in the lower leg undergoes an amputation through the tibia and fibula, with immediate fitting technique including the application of the first cast.
5. A patient with a severe infection in the lower leg undergoes an amputation through the tibia and fibula, with immediate fitting technique including the application of the first cast.
6. An individual with a congenital limb deformity undergoes an amputation through the tibia and fibula, with immediate fitting technique including the application of the first cast.
7. A patient with a nonhealing ulcer in the lower leg undergoes an amputation through the tibia and fibula, with immediate fitting technique including the application of the first cast.
8. An individual with a severe crush injury to the lower leg requires an amputation through the tibia and fibula, with immediate fitting technique including the application of the first cast.
9. A patient with a chronic condition causing severe pain in the lower leg undergoes an amputation through the tibia and fibula, with immediate fitting technique including the application of the first cast.
10. An individual with a failed previous surgical procedure in the lower leg requires an amputation through the tibia and fibula, with immediate fitting technique including the application of the first cast.