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Official Description

Closed treatment of knee dislocation; without anesthesia

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Knee dislocation is classified as a significant and relatively uncommon injury that necessitates prompt recognition and treatment to prevent complications, such as vascular impairment. This condition occurs when the bones of the knee joint are displaced from their normal alignment, which can lead to severe pain, swelling, and potential damage to surrounding structures, including blood vessels and nerves. In the absence of timely intervention, vascular impairment may occur, which is why it is critical to assess peripheral pulses immediately upon diagnosis. If vascular impairment is detected, the physician may proceed with reduction of the dislocation without the need for pre-reduction radiographs. Conversely, if peripheral pulses are intact, the physician may opt to obtain separate radiographs to evaluate the extent of the injury before proceeding with treatment. The reduction process typically involves the application of longitudinal traction to realign the dislocated joint. After the successful reduction, a follow-up set of radiographs may be taken to confirm proper alignment. Post-reduction care includes splinting the leg and providing the patient with instructions to ice and elevate the knee to manage swelling and promote healing. The CPT® code 27550 is specifically utilized when the dislocation is treated without the use of anesthesia, while the code 27552 is designated for cases where anesthesia is administered during the procedure.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The closed treatment of knee dislocation without anesthesia is indicated in the following scenarios:

  • Knee Dislocation This procedure is performed when a patient presents with a dislocated knee joint, which may be accompanied by significant pain and swelling.
  • Vascular Impairment Assessment The procedure is indicated when there is a need to assess and address potential vascular impairment associated with the dislocation.
  • Presence of Peripheral Pulses If peripheral pulses are intact, this procedure may be indicated to realign the dislocated joint without the use of anesthesia.

2. Procedure

The closed treatment of knee dislocation without anesthesia involves several critical procedural steps:

  • Initial Assessment Upon presentation, the physician conducts a thorough assessment of the knee to confirm the dislocation and check for any signs of vascular impairment. This includes evaluating the presence of peripheral pulses to determine the urgency of the intervention.
  • Decision on Radiographs If vascular impairment is suspected, the physician may proceed directly to reduction without obtaining pre-reduction radiographs. However, if peripheral pulses are present, the physician may choose to obtain separate radiographs to assess the injury further before proceeding with treatment.
  • Reduction Technique The physician applies longitudinal traction to the affected leg to facilitate the reduction of the dislocated knee joint. This technique aims to realign the bones of the knee back into their proper anatomical position.
  • Post-Reduction Radiographs After the reduction is successfully performed, a second set of radiographs may be obtained to confirm that the knee joint is properly aligned and to rule out any additional injuries.
  • Post-Procedure Care Following the reduction, the leg is splinted to maintain stability and prevent further injury. The patient is then instructed on post-procedure care, which includes icing the knee and elevating the leg to reduce swelling and promote healing.

3. Post-Procedure

After the closed treatment of knee dislocation without anesthesia, the patient is advised to follow specific post-procedure care instructions. This includes keeping the leg elevated to minimize swelling and applying ice to the affected area to alleviate pain and reduce inflammation. The splint is typically left in place to provide support and stability to the knee during the initial recovery phase. The physician may schedule a follow-up appointment to monitor the healing process and assess the need for further imaging or intervention, depending on the patient's progress and any potential complications that may arise.

Short Descr TREAT KNEE DISLOCATION
Medium Descr CLOSED TX KNEE DISLOCATION W/O ANESTHESIA
Long Descr Closed treatment of knee dislocation; without anesthesia
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) 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 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) P6B - Minor procedures - musculoskeletal
MUE 1
CCS Clinical Classification 147 - Treatment, fracture or dislocation of lower extremity (other than hip or 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).
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).
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.
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.)
AM Physician, team member service
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
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)
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
RT Right side (used to identify procedures performed on the right side of the body)
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
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Pre-1990 Added Code added.
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