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Bilateral osteotomies of the pelvis, as described by CPT® Code 27158, are surgical procedures aimed at correcting congenital malformations of the pelvis that lead to issues such as bilateral subluxation or dislocation of the hips. These malformations can significantly impact a patient's mobility and overall quality of life. The procedure involves a careful assessment of the pelvic structure to determine the specific areas that require surgical intervention. During the operation, the surgeon exposes the bones that need to be reshaped through osteotomy, which is the surgical cutting of bone. The planned sites for the osteotomy are meticulously marked to ensure precision in the surgical approach. Once the cuts are made, the shape of the pelvis can be reconfigured to restore proper alignment and function. Wedges created from the excised bone are strategically placed at the osteotomy sites to maintain the desired angles and stability of the bones. To secure the bones in their new positions, internal fixation devices such as pins, screws, or wires may be utilized, ensuring that the pelvis heals correctly and functions optimally post-surgery.
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The procedure described by CPT® Code 27158 is indicated for specific conditions related to congenital malformations of the pelvis. These indications include:
The surgical procedure for bilateral osteotomy of the pelvis involves several critical steps, which are outlined as follows:
After the bilateral osteotomy of the pelvis, patients typically require a period of recovery that may involve pain management and physical therapy. The surgical site will need to be monitored for signs of infection or complications. Patients are often advised to limit weight-bearing activities during the initial healing phase to ensure proper recovery. Follow-up appointments are essential to assess the healing process and to make any necessary adjustments to the rehabilitation plan. The overall goal of post-procedure care is to restore function and mobility while minimizing the risk of complications.
| Short Descr | REVISION OF PELVIS | Medium Descr | OSTEOTOMY PELVIS BILATERAL | Long Descr | Osteotomy, pelvis, bilateral (eg, congenital malformation) | 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) | 2 - 150% payment adjustment does NOT apply. | 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) | 0 - Co-surgeons not permitted for this procedure. | 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 |
| 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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.) |
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| Pre-1990 | Added | Code added. |
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