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The CPT® Code 27256 refers to the treatment of spontaneous hip dislocation, specifically in cases of developmental dysplasia of the hip (DDH). This condition can arise from congenital malformations or may develop over time, impacting the osseous structures, joint capsule, and soft tissues surrounding the hip joint. The procedure described by this code involves a non-invasive approach to address the dislocation without the use of anesthesia or manipulation. Initially, the dislocated hip may require manual reduction, which utilizes traction and mechanical forces to reposition the femoral head back into the acetabulum, the socket of the hip joint. Following this, the maintenance of the hip's correct position is achieved through methods such as abduction, splinting, or traction. Abduction is typically facilitated by a Pavlik harness, which is designed to hold both legs in an abducted position, ensuring proper alignment and stability. In instances where the harness or splinting techniques are ineffective, skin traction may be employed. This involves the application of a boot or adhesive strapping to the lower leg, with additional support provided by ace wraps and a system of ropes and weights to maintain traction. The use of CPT® Code 27256 is appropriate when these procedures are conducted without anesthesia and without the need for manipulation, distinguishing it from CPT® Code 27257, which is used when anesthesia and manipulation are involved in the reduction process.
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The procedure associated with CPT® Code 27256 is indicated for the treatment of spontaneous hip dislocation due to developmental dysplasia of the hip (DDH). This condition may manifest as a result of congenital malformations or may develop during the growth process, leading to dislocation of the hip joint. The following specific indications apply:
The procedure for CPT® Code 27256 involves several key steps to effectively treat spontaneous hip dislocation:
After the procedure associated with CPT® Code 27256, the patient will require careful monitoring to ensure the effectiveness of the treatment. Post-procedure care includes regular follow-up appointments to assess the position of the hip joint and the effectiveness of the abduction method used. The healthcare provider will evaluate the skin condition under the traction or harness to prevent any complications such as skin irritation or pressure sores. The patient may also be advised on specific activities to avoid during the recovery period to ensure proper healing and alignment of the hip joint. Education on the use of the Pavlik harness or traction methods will be provided to the patient or caregivers to ensure compliance and effectiveness of the treatment plan.
| Short Descr | TREAT HIP DISLOCATION | Medium Descr | TX SPONTAN HIP DISLC ABDCT SPLNT/TRCJ W/O ANES | Long Descr | Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; without anesthesia, without manipulation | Status Code | Active Code | Global Days | 010 - Minor Procedure | 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) | 0 - 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 | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6B - Minor procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 146 - Treatment, fracture or dislocation of hip and femur |
| 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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). | 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. | 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. | 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.) | 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). | GW | Service not related to the hospice patient's terminal condition | 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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