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Arthrotomy with synovectomy of the hip joint, designated by CPT® Code 27054, is a surgical procedure aimed at addressing conditions affecting the synovial tissue within the hip joint. The term 'synovectomy' refers to the surgical removal of the synovial membrane, which is the lining of the joint that produces synovial fluid, essential for lubricating and nourishing the joint. In cases where this tissue becomes inflamed due to various conditions such as arthritis or other joint diseases, a synovectomy may be indicated to alleviate pain and restore function. The procedure begins with a skin incision made over the lateral aspect of the hip joint, allowing access to the underlying soft tissues. Surgeons carefully dissect through these tissues to reach the joint capsule, which is then opened to provide a clear view of the hip joint's interior. During the operation, the surgeon examines the joint for any signs of injury or disease, ensuring a comprehensive assessment. The inflamed synovial tissue is excised using a specialized instrument known as a synovial resector, which facilitates the precise removal of the affected tissue. After the synovectomy is completed, the joint is thoroughly flushed with sterile saline to cleanse the area and promote healing. Finally, the incisions are meticulously closed to ensure proper recovery and minimize the risk of infection.
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Arthrotomy with synovectomy of the hip joint is indicated for various conditions that lead to inflammation of the synovial tissue. The following are specific indications for this procedure:
The procedure of arthrotomy with synovectomy involves several critical steps to ensure effective removal of the inflamed synovial tissue. The following outlines the procedural steps:
Post-procedure care following an arthrotomy with synovectomy of the hip joint typically involves monitoring for any signs of complications, such as infection or excessive swelling. Patients may be advised to rest the joint and limit weight-bearing activities for a specified period to promote healing. Physical therapy may be recommended to restore range of motion and strength in the hip joint. Follow-up appointments are essential to assess recovery progress and ensure that the joint is healing properly. Additionally, patients should be educated on signs of potential complications that warrant immediate medical attention.
| Short Descr | REMOVAL OF HIP JOINT LINING | Medium Descr | ARTHROTOMY W/SYNOVECTOMY HIP JOINT | Long Descr | Arthrotomy with synovectomy, hip joint | 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 | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 162 - Other OR therapeutic procedures on joints |
| 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. | RT | Right side (used to identify procedures performed on the right side of the body) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | LT | Left side (used to identify procedures performed on the left side of the body) | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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). | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | ET | Emergency services | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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