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Decompression fasciotomy is a surgical procedure aimed at alleviating the pressure within a muscle compartment, which is critical in treating compartment syndrome. Compartment syndrome occurs when swelling within a muscle compartment leads to increased pressure that can compress blood vessels and nerves, potentially resulting in irreversible damage to the muscles and nerves if not addressed promptly. The muscle compartments are encased in fascia, a dense connective tissue that does not stretch, thus any swelling can lead to significant complications. In the thigh and knee regions, there are three primary compartments: the flexor, extensor, and adductor compartments. The CPT® Code 27497 specifically refers to the decompression of one of these compartments, accompanied by the debridement of any nonviable muscle and/or nerve tissue. This procedure involves making an incision over the lateral aspect of the thigh, allowing for access to the affected compartment. The surgical approach includes careful dissection of the subcutaneous tissue and iliotibial band, followed by the reflection of the vastus lateralis muscle to access the compartment. The procedure is critical in preventing long-term damage and ensuring the restoration of normal function in the affected limb.
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Decompression fasciotomy is indicated for the treatment of compartment syndrome, which can arise from various conditions leading to increased pressure within a muscle compartment. The following are specific indications for performing this procedure:
The procedure for decompression fasciotomy involves several critical steps to ensure effective treatment of compartment syndrome:
After the decompression fasciotomy, the patient will require careful monitoring and post-operative care. The incisions are left open to allow for any residual swelling to decrease, and they are covered with a sterile dressing to protect the area. The patient may need to be observed for signs of infection or complications related to the procedure. Once the swelling has subsided, typically within 24 to 72 hours, the patient will return to the operating room for closure of the incisions. Rehabilitation and physical therapy may be necessary to restore function and strength in the affected limb following the procedure.
| Short Descr | DECOMPRESSION OF THIGH/KNEE | Medium Descr | DCMPRN FASCT THIGH&/KNEE DBRDMT MUSCLE&/NERVE | Long Descr | Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor); with debridement of nonviable muscle and/or nerve | 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) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | 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) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 160 - Other therapeutic procedures on muscles and tendons |
| 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). | 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. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 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 | 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) | 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 |
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| 2010-01-01 | Changed | Code description changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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