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Closed treatment of a proximal end femoral head fracture, as described by CPT® Code 27267, refers to a non-surgical approach to managing a specific type of fracture located at the upper end of the femur, known as the femoral head. This type of fracture typically occurs in younger individuals as a result of trauma, such as falls or accidents. The procedure is characterized by the absence of manipulation, meaning that the fractured bone fragments are not physically repositioned during the treatment. Instead, the focus is on assessing the stability of the fracture through radiographic studies, which are reported separately. If the fracture is determined to be nondisplaced or minimally displaced, the anatomical position of the femoral head is evaluated, and the range of motion is assessed for any signs of abnormality, such as crepitation, which is a crackling or popping sound that may indicate instability. Patients are advised to avoid putting weight on the injured leg and are typically provided with crutches or other assistive devices to aid in mobility. It is important to note that if manipulation is required to treat a displaced fracture, CPT® Code 27268 should be used instead, as it involves a closed reduction procedure where the bone fragments are manually realigned to facilitate proper healing.
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Closed treatment of a proximal end femoral head fracture is indicated for patients who present with specific symptoms or conditions related to this type of injury. The following are the explicitly provided indications for performing this procedure:
The procedure for closed treatment of a proximal end femoral head fracture without manipulation involves several key steps, which are detailed as follows:
Post-procedure care for a closed treatment of a proximal end femoral head fracture includes monitoring the patient's recovery and adherence to weight-bearing restrictions. Patients are advised to follow up with their healthcare provider for ongoing assessments of the fracture's healing process. It is important for patients to report any changes in symptoms, such as increased pain or instability, as these may indicate complications. Rehabilitation may be recommended to restore strength and mobility once the fracture has sufficiently healed, and the patient is cleared to gradually resume normal activities.
| Short Descr | CLTX THIGH FX | Medium Descr | CLOSED TX FEMORAL FRACTURE PROX HEAD W/O MANJ | Long Descr | Closed treatment of femoral fracture, proximal end, head; without manipulation | 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 | Hospital Part B services paid through a comprehensive APC | 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) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 146 - Treatment, fracture or dislocation of hip and femur |
| 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. | 55 | Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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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| 2008-01-01 | Added | First appearance in code book in 2008. |
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