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Official Description

Manipulation, hip joint, requiring general anesthesia

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 27275 refers to the manipulation of the hip joint while the patient is under general anesthesia. This manipulation is specifically performed to address issues related to fibrous adhesions and scar tissue that may have developed around the hip joint. Such adhesions can restrict movement and cause discomfort, making it difficult for the patient to perform daily activities. The use of general anesthesia is crucial in this context, as it allows for a pain-free experience during the procedure, particularly for patients who may be experiencing significant pain, muscle spasms, or guarding that would otherwise hinder the manipulation process. During the procedure, the hip joint is subjected to a series of controlled stretches and articular maneuvers. These actions aim to break up the fibrous adhesions and scar tissue, thereby restoring mobility and increasing the range of motion in the hip joint. This manipulation is an important therapeutic intervention for patients suffering from limited hip function due to these conditions.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The manipulation of the hip joint under general anesthesia, as described by CPT® Code 27275, is indicated for patients experiencing specific conditions that necessitate intervention to restore hip mobility. The following are the primary indications for this procedure:

  • Fibrous Adhesions - The presence of fibrous tissue that has formed around the hip joint, which can limit movement and cause discomfort.
  • Scar Tissue - Development of scar tissue as a result of previous injuries, surgeries, or inflammatory conditions that restrict the normal range of motion of the hip joint.
  • Severe Pain - Patients who are unable to tolerate manipulation of the hip joint due to significant pain that may arise from underlying conditions affecting the joint.
  • Muscle Spasms - Involuntary contractions of the muscles surrounding the hip joint that can impede movement and require intervention to alleviate.
  • Guarding - A protective response where the patient involuntarily restricts movement of the hip joint due to pain or discomfort, necessitating manipulation to restore function.

2. Procedure

The procedure for manipulation of the hip joint under general anesthesia involves several critical steps to ensure effective treatment and patient safety. The following outlines the procedural steps:

  • Step 1: Anesthesia Administration - The procedure begins with the administration of general anesthesia to the patient. This is essential to ensure that the patient remains completely unconscious and free from pain during the manipulation process, allowing for a more effective intervention.
  • Step 2: Positioning the Patient - Once the patient is under anesthesia, they are carefully positioned to provide optimal access to the hip joint. Proper positioning is crucial to facilitate the manipulation and to ensure the safety and comfort of the patient throughout the procedure.
  • Step 3: Joint Manipulation - The surgeon then performs a series of controlled stretches and articular maneuvers on the hip joint. These movements are designed to break up any fibrous adhesions and scar tissue that may be present, thereby restoring mobility and increasing the range of motion in the joint.
  • Step 4: Assessment of Mobility - After the manipulation, the surgeon assesses the hip joint's mobility to determine the effectiveness of the procedure. This may involve testing the range of motion and evaluating the patient's response to the manipulation.
  • Step 5: Recovery from Anesthesia - Following the completion of the manipulation, the patient is monitored as they recover from anesthesia. This includes ensuring that the patient is stable and comfortable before they are discharged from the surgical setting.

3. Post-Procedure

After the manipulation of the hip joint, patients typically require a period of recovery to allow for healing and to monitor for any potential complications. Post-procedure care may include pain management strategies, physical therapy to enhance mobility, and instructions for activity restrictions to prevent strain on the hip joint. Patients are often advised to gradually increase their activity levels as tolerated and to follow up with their healthcare provider to assess the success of the procedure and to make any necessary adjustments to their rehabilitation plan. It is important for patients to adhere to the post-procedure guidelines provided by their healthcare team to ensure optimal recovery and outcomes.

Short Descr MANIPULATION OF HIP JOINT
Medium Descr MANIPULATION HIP JOINT GENERAL ANESTHESIA
Long Descr Manipulation, hip joint, requiring general anesthesia
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) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
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 Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5B - Ambulatory procedures - musculoskeletal
MUE 2
CCS Clinical Classification 162 - Other OR therapeutic procedures on joints
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.
RT Right side (used to identify procedures performed on the right side of the body)
LT Left side (used to identify procedures performed on the left side of the body)
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).
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).
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.
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.
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.
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.)
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
ET Emergency services
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
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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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