How To Use CPT Code 27889

CPT 27889 describes the procedure for ankle disarticulation, which involves the amputation of the foot at the ankle joint without cutting bone. 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 27889?

CPT 27889 is used to describe the surgical procedure known as ankle disarticulation. This procedure involves the amputation of the foot at the ankle joint without cutting bone. It is typically performed to address nonhealing wounds caused by infection or poor circulation, or to treat traumatic injuries.

2. Official Description

The official description of CPT code 27889 is: ‘Ankle disarticulation; primary procedure.’

3. Procedure

1. The patient is appropriately prepped and anesthetized for the procedure.
2. The provider makes an incision at the distal tips of the lateral malleolus and medial malleolus.
3. The incision is deepened through the subcutaneous tissue and muscles to expose the area of amputation.
4. The provider dissects the ligaments, muscles, and ligates the major blood vessels at the site.
5. The foot is removed between the bones of the ankle joint.
6. Tendons and ligaments are severed.
7. The area is irrigated with antibiotics, checked for bleeding, and any instruments are removed.
8. The incision is closed in layers.

4. Qualifying circumstances

Ankle disarticulation is performed on patients who have nonhealing wounds from infection or poor circulation, or who have suffered traumatic injuries. The procedure is typically performed by a qualified healthcare professional and requires appropriate prepping and anesthesia.

5. When to use CPT code 27889

CPT code 27889 should be used when ankle disarticulation is the primary procedure performed. It is important to ensure that the procedure is accurately documented and meets the criteria outlined in the official description.

6. Documentation requirements

To support a claim for CPT code 27889, the following documentation is required:

• Reason for the procedure, such as nonhealing wounds or traumatic injury
• Details of the surgical technique used
• Date of the procedure
• Preparation and anesthesia administered
• Incision site and depth
• Steps taken to dissect ligaments, muscles, and ligate blood vessels
• Removal of the foot and severing of tendons and ligaments
• Irrigation with antibiotics and assessment of bleeding
• Closure of the incision in layers

7. Billing guidelines

When billing for CPT code 27889, it is important to follow the appropriate guidelines. Ensure that the procedure is accurately documented and meets the criteria outlined in the official description. Modifier 50, Bilateral procedure, should be used if ankle disarticulation is performed on both ankles.

8. Historical information

CPT code 27889 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes ankle disarticulation due to nonhealing wounds caused by poor circulation.
2. An individual sustains a traumatic injury to the ankle and requires ankle disarticulation as a result.
3. A healthcare professional performs ankle disarticulation on a patient with an infected wound that has not responded to other treatments.
4. An individual with a history of nonhealing wounds undergoes ankle disarticulation to improve their overall health and quality of life.
5. A patient with a severe traumatic injury to the ankle undergoes ankle disarticulation to prevent further complications.
6. Ankle disarticulation is performed on a patient with a chronic condition that has led to nonhealing wounds and significant pain.
7. A healthcare professional recommends ankle disarticulation as the most appropriate treatment option for a patient with a nonhealing wound caused by poor circulation.
8. An individual with a traumatic injury to the ankle undergoes ankle disarticulation to improve their mobility and quality of life.
9. Ankle disarticulation is performed on a patient with a severe infection that has not responded to other treatments.
10. A healthcare professional determines that ankle disarticulation is necessary to address a patient’s nonhealing wound and prevent further complications.