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The procedure described by CPT® Code 27120, known as acetabuloplasty, involves the surgical reshaping of the acetabulum, which is the cup-shaped depression located on the external surface of the pelvis. This procedure is primarily performed to enhance the functionality of the hip joint, particularly in cases where there are deformities affecting the acetabulum. Various surgical techniques, such as those developed by Whitman, Colonna, Haygroves, or the cup type, may be employed depending on the specific nature and severity of the deformity present. The surgical approach typically begins with an incision made over the lateral aspect of the hip, allowing for the dissection and release of soft tissue to gain access to the hip joint. Once the joint is exposed, the femoral head is dislocated from the acetabulum to facilitate the reshaping process. The surgeon then utilizes an osteotome to remove cartilage and bone from the acetabular surface, preparing it for the placement of a prosthetic cup. This cup is securely attached to the acetabulum, and the femoral head is subsequently relocated within this newly formed socket. The procedure concludes with the closure of the incisions in layers, ensuring proper healing. In cases of congenital hip deformity, additional steps may be taken, such as placing the femoral head deep within the acetabular socket and performing bone grafting to fill any gaps created during the osteotomy. The hip is then positioned in abduction and a hip spica cast is applied to support the healing process, allowing the femoral head to mold the acetabulum as it heals, ultimately forming a hemispherically shaped socket.
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The acetabuloplasty procedure is indicated for various conditions affecting the hip joint, particularly those that involve deformities of the acetabulum. The following are specific indications for performing this procedure:
The acetabuloplasty procedure involves several critical steps to ensure the successful reshaping of the acetabulum. The following outlines the procedural steps:
Post-procedure care following acetabuloplasty is essential for ensuring proper recovery and function of the hip joint. Patients are typically monitored for any complications and provided with pain management as needed. The application of a hip spica cast, particularly in cases involving congenital deformities, is crucial as it helps maintain the position of the femoral head within the acetabulum during the healing process. As the acetabulum heals, the femoral head serves as a mold for the socket, and as bone callus forms, it conforms to the shape of the femoral head, ultimately resulting in a hemispherically shaped socket. Patients may require physical therapy to regain strength and mobility in the hip joint as they progress through their recovery. Regular follow-up appointments are necessary to assess healing and ensure the proper function of the hip joint.
| Short Descr | RECONSTRUCTION OF HIP SOCKET | Medium Descr | ACETABULOPLASTY | Long Descr | Acetabuloplasty; (eg, Whitman, Colonna, Haygroves, or cup type) | 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 |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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). | 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. | 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. | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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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