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The CPT® Code 27222 refers to the closed treatment of fractures occurring in the acetabulum, which is the socket of the hip joint. This procedure involves manipulation of the fracture, which may be accompanied by the use of skeletal traction. The closed treatment signifies that the procedure is performed without making an incision to access the fracture site directly. The physician begins by obtaining necessary imaging studies, such as radiographs or a CT scan, to assess the extent of the injury to the hip region. This imaging is crucial for evaluating the fracture's characteristics and planning the appropriate treatment approach. During the examination, the physician palpates the anterior and posterior pelvic bones, as well as the greater trochanter, to assess the injury's impact on the surrounding structures. Additionally, the range of motion of the hip and lumbosacral spine is evaluated to determine any limitations or pain associated with the injury. A neurovascular examination is also performed to check for any signs of nerve impingement, ensuring that the patient does not have compromised blood flow or nerve function. In cases where the fracture is classified as nondisplaced or minimally displaced, as indicated by CPT® Code 27220, treatment may involve conservative measures such as bed rest and the use of assistive devices like crutches or a walker to facilitate ambulation without putting weight on the affected side. However, for more complex fractures requiring manipulation, as described in CPT® Code 27222, the physician will manually reduce the fracture fragments. To maintain the proper alignment of the fracture during the healing process, skeletal traction may be employed. This involves the insertion of a pin into the proximal aspect of the tibia, to which a traction device is attached, utilizing weights to ensure that the fracture remains properly reduced throughout the recovery period.
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The closed treatment of acetabulum fractures with manipulation, as described by CPT® Code 27222, is indicated for specific conditions related to hip socket injuries. The following are the explicitly provided indications for this procedure:
The procedure for the closed treatment of acetabulum fractures with manipulation involves several critical steps to ensure effective treatment and recovery. The following procedural steps are outlined:
After the closed treatment of the acetabulum fracture with manipulation, several post-procedure care considerations are essential for optimal recovery. Patients may be advised to rest and avoid weight-bearing activities on the affected side to promote healing. The use of assistive devices, such as crutches or a walker, may be prescribed to facilitate safe ambulation without putting stress on the fracture site. Regular follow-up appointments are necessary to monitor the healing process, assess the alignment of the fracture, and make any necessary adjustments to the treatment plan. The physician may also recommend physical therapy to help restore strength and range of motion as the healing progresses. It is important for patients to adhere to the post-procedure instructions and report any unusual symptoms, such as increased pain or swelling, to their healthcare provider promptly.
| Short Descr | TREAT HIP SOCKET FRACTURE | Medium Descr | CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ | Long Descr | Closed treatment of acetabulum (hip socket) fracture(s); with manipulation, with or without skeletal traction | 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) | 1 - Statutory payment restriction for assistants at surgery applies 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 | 146 - Treatment, fracture or dislocation of hip and femur |
| LT | Left side (used to identify procedures performed on the left side of the body) | 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. | 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). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 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.) | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | FS | Split (or shared) evaluation and management visit | 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 | RT | Right side (used to identify procedures performed on the right side of the body) | 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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| Pre-1990 | Added | Code added. |
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