How To Use CPT Code 27882

CPT 27882 describes the procedure for amputation of the leg through the tibia and fibula, specifically an open, circular (guillotine) amputation. 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 27882?

CPT 27882 is used to describe the surgical procedure of amputating the leg below the knee without leaving a skin flap. This procedure is performed when there is a need for rapid amputation to stop rapidly ascending necrosis or hemodynamic compromise. It involves the removal of the leg through the tibia and fibula in a circular (guillotine) fashion.

2. Official Description

The official description of CPT code 27882 is: ‘Amputation, leg, through tibia and fibula; open, circular (guillotine).’ This procedure is performed to remove diseased tissue or relieve pain by intentionally surgically removing a limb or body part.

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. A sterile tourniquet is applied to arrest blood flow to the leg, and the leg is elevated.
3. The provider uses an oscillating, or circular, saw to amputate the leg below the knee through the skin, subcutaneous tissues, and bone in one sweep.
4. Bleeding vessels are ligated, or tied off, to control blood loss.
5. A moist bulky dressing is applied.
6. In the presence of infection, antibiotic treatment is initiated.
7. The patient may undergo revision amputation once stabilized.

4. Qualifying circumstances

CPT 27882 is performed when there is a need for rapid amputation to stop rapidly ascending necrosis or hemodynamic compromise. It is typically done in cases where preserving a skin flap is not necessary or feasible. The procedure is performed by a qualified healthcare professional who has the necessary expertise in performing amputations.

5. When to use CPT code 27882

CPT code 27882 should be used when performing an open, circular (guillotine) amputation of the leg through the tibia and fibula. It is important to ensure that the specific circumstances requiring this procedure are met before reporting this code.

6. Documentation requirements

To support a claim for CPT 27882, the healthcare professional must document the following information:

• Reason for the amputation, such as rapidly ascending necrosis or hemodynamic compromise
• Details of the procedure, including the use of an oscillating saw and ligation of bleeding vessels
• Date and time of the procedure
• Any complications or additional treatments provided
• Signature of the performing healthcare professional

7. Billing guidelines

When billing for CPT 27882, ensure that the procedure performed matches the description of the code. It is important to follow the specific guidelines provided by the payer and accurately document the procedure to support the claim. Additionally, be aware of any specific coding requirements or modifiers that may be necessary for proper reimbursement.

8. Historical information

CPT 27882 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 added and removed from the Inpatient Only (IPO) list in different years.

9. Examples

1. A patient with rapidly ascending necrosis undergoes an open, circular amputation of the leg through the tibia and fibula to prevent further tissue damage.
2. In a case of hemodynamic compromise, a guillotine amputation is performed on the leg through the tibia and fibula to stabilize the patient’s condition.
3. A patient with severe pain and infection in the leg undergoes an open, circular amputation to relieve their symptoms and prevent further complications.
4. Following a traumatic injury, a patient requires a guillotine amputation of the leg through the tibia and fibula to facilitate their recovery and rehabilitation.
5. In a case of advanced cancer, an open, circular amputation is performed on the leg through the tibia and fibula to remove the diseased tissue and improve the patient’s quality of life.
6. A patient with a severe infection in the leg undergoes a guillotine amputation to prevent the spread of the infection and preserve their overall health.
7. Following unsuccessful conservative treatments, a patient with a chronic condition undergoes an open, circular amputation of the leg through the tibia and fibula to alleviate their symptoms and improve their mobility.
8. In a case of severe trauma, a guillotine amputation is performed on the leg through the tibia and fibula to save the patient’s life and prevent further complications.
9. A patient with a non-healing wound and compromised blood flow undergoes an open, circular amputation to promote healing and prevent further tissue damage.
10. In a case of severe peripheral artery disease, a guillotine amputation is performed on the leg through the tibia and fibula to improve blood flow and prevent complications.