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The procedure described by CPT® Code 27003 refers to a surgical intervention known as a tenotomy of the adductor muscle, which is located on the inner side of the hip joint. This specific procedure is performed through an open approach and involves the subcutaneous layer, meaning that the incision is made through the skin and the underlying tissues without penetrating deeper structures unnecessarily. The primary purpose of an adductor tenotomy is to address conditions such as congenital hip dislocation or adduction contracture, which may occur in patients with spastic type cerebral palsy. These conditions can lead to abnormal positioning of the hip joint, necessitating surgical intervention to restore proper alignment and function. In this procedure, the surgeon not only performs the tenotomy, which involves cutting the adductor tendon to relieve tension, but also conducts an obturator neurectomy. This additional step involves the identification and excision of a portion of the anterior branch of the obturator nerve, which can help alleviate spasticity and improve the overall outcome of the surgery. Following the tenotomy and neurectomy, the femoral head is carefully repositioned within the acetabulum, the socket of the hip joint, to ensure proper alignment. To stabilize the hip joint post-surgery, a hip spica cast is applied, which immobilizes the area and supports the healing process. This comprehensive approach aims to enhance mobility and function in patients suffering from the aforementioned conditions.
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The procedure described by CPT® Code 27003 is indicated for specific conditions that affect the hip joint and its surrounding structures. These indications include:
The procedure for CPT® Code 27003 involves several critical steps that ensure the successful execution of the adductor tenotomy with obturator neurectomy. These steps include:
Post-procedure care following CPT® Code 27003 involves monitoring the patient for any complications and ensuring proper healing of the surgical site. The application of the hip spica cast is critical, as it provides the necessary immobilization to support recovery. Patients may require follow-up visits to assess the healing process and to make any necessary adjustments to the cast. Rehabilitation may also be initiated to restore mobility and strength in the hip joint once the initial healing phase is complete. It is essential for healthcare providers to educate patients and caregivers about the importance of adhering to post-operative instructions to achieve the best possible outcomes.
| Short Descr | INCISION OF HIP TENDON | Medium Descr | TX ADDUXOR SUBQ OPN W/OBTURATOR NEURECTOMY | Long Descr | Tenotomy, adductor, subcutaneous, open, with obturator neurectomy | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 9 - Other OR therapeutic nervous system procedures |
| 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| Pre-1990 | Added | Code added. |
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