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The CPT® Code 27218 refers to the open treatment of posterior pelvic bone fractures and/or dislocations, specifically for fracture patterns that disrupt the pelvic ring on a unilateral basis. This procedure includes internal fixation when performed, which may involve the ipsilateral ilium, sacroiliac joint, and/or sacrum. Posterior pelvic ring fractures typically involve injuries to the ilium and/or sacrum, and they can also include dislocation or fracture dislocation injuries affecting the sacroiliac joints. To accurately assess the extent of the injury to the posterior pelvic ring, a radiographic study of the pelvis is conducted, which is separately reportable. The surgical approach involves making an incision to expose the fracture or dislocation site, followed by the removal of any debris to facilitate a clear view of the injury. Once the site is adequately prepared, the fracture or dislocation is reduced to restore anatomical alignment. After achieving proper reduction, the bone is prepared for the application of an internal fixation device, which may consist of screws, a transiliac sacral bar (commonly known as a Harrington rod), or a plate and screw fixation device. The procedure is completed by verifying the alignment of the fracture fragments through radiographic imaging, followed by the irrigation and closure of the wound.
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The procedure described by CPT® Code 27218 is indicated for specific conditions related to posterior pelvic bone fractures and/or dislocations. These indications include:
The open treatment of posterior pelvic bone fractures and/or dislocations involves several critical procedural steps, which are detailed as follows:
Post-procedure care following the open treatment of posterior pelvic bone fractures and/or dislocations includes monitoring for any signs of complications, such as infection or improper healing. Patients may require pain management and physical therapy to aid in recovery. Follow-up appointments are essential to assess the healing process and to conduct any necessary imaging studies to ensure that the internal fixation devices are functioning as intended. The expected recovery time may vary based on the severity of the injury and the individual patient's health status.
| Short Descr | TREAT PELVIC RING FRACTURE | Medium Descr | OPTX POST PEL BONE FX&/DISLC INT FIXJ IF PFRMD | Long Descr | Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes ipsilateral ilium, sacroiliac joint and/or sacrum) | Status Code | Not Valid for Medicare Purposes | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Non-Covered Service, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 0 | CCS Clinical Classification | 148 - Other fracture and dislocation procedure |
| 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. | CR | Catastrophe/disaster related | 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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| 2009-01-01 | Changed | Code description changed |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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