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Official Description

Open treatment of knee dislocation, includes internal fixation, when performed; without primary ligamentous repair or augmentation/reconstruction

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 27556 refers to the open treatment of a knee dislocation, which is a significant injury involving the displacement of the knee joint. This procedure includes internal fixation when necessary but does not involve primary ligamentous repair or augmentation/reconstruction. Knee dislocations can be categorized into five types: anterior, posterior, lateral, medial, and rotary, each varying in the specific ligaments affected and the severity of the injury. The treatment approach is tailored based on these factors. During the procedure, a surgical incision is made over the knee, allowing access to the joint capsule. The surgeon then incises the capsule to expose the injury site, which is meticulously cleared of any debris, including loose osteochondral fragments that may hinder proper healing. Following this, the dislocated knee is reduced, meaning the bones are realigned into their proper position, and this alignment is confirmed through radiographic imaging. The stability of the knee is subsequently assessed, and if deemed necessary, internal fixation devices are applied to ensure that the knee remains properly aligned and stable during the healing process. Finally, the surgical site is irrigated to prevent infection, and the incision is closed with sutures, completing the procedure.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 27556 is indicated for patients who have sustained a knee dislocation. This condition may arise from various traumatic events, and the specific indications for performing this open treatment include:

  • Knee Dislocation Types The procedure is applicable for anterior, posterior, lateral, medial, and rotary knee dislocations, depending on the specific ligaments involved and the severity of the injury.
  • Severe Ligament Injury Indications may include cases where there is significant damage to the knee ligaments that necessitates surgical intervention for proper alignment and stabilization.
  • Failure of Conservative Treatment The procedure may be indicated when non-surgical methods, such as immobilization or physical therapy, have failed to restore knee stability.

2. Procedure

The open treatment of knee dislocation as described in CPT® Code 27556 involves several critical procedural steps:

  • Step 1: Incision The procedure begins with the surgeon making a surgical incision over the knee to gain access to the joint. This incision is strategically placed to allow for optimal exposure of the knee joint and surrounding structures.
  • Step 2: Incising the Joint Capsule Following the incision, the joint capsule is incised. This step is crucial as it allows the surgeon to access the internal structures of the knee, including the ligaments and cartilage that may be affected by the dislocation.
  • Step 3: Exposure and Debridement Once the joint capsule is incised, the injury site is exposed. The surgeon carefully clears the area of any debris, such as loose osteochondral fragments, which could impede the healing process and affect the stability of the knee.
  • Step 4: Reduction of the Dislocation The next step involves the reduction of the knee dislocation. This means that the surgeon realigns the bones of the knee joint back into their proper anatomical position. This step is critical for restoring function and stability to the knee.
  • Step 5: Radiographic Confirmation After the reduction, the alignment of the knee is checked radiographically. This imaging confirms that the bones are properly aligned and that the dislocation has been successfully corrected.
  • Step 6: Stability Assessment The stability of the knee is then assessed to ensure that the joint is secure and that there are no further issues that could lead to re-dislocation or instability.
  • Step 7: Internal Fixation If necessary, internal fixation devices are applied to maintain the alignment and stability of the knee joint. This may involve the use of screws, plates, or other fixation devices, depending on the specific needs of the patient.
  • Step 8: Wound Irrigation and Closure Finally, the surgical site is irrigated to reduce the risk of infection, and the incision is closed with sutures, completing the procedure.

3. Post-Procedure

After the open treatment of knee dislocation, patients typically require careful monitoring and follow-up care. Post-procedure care may include pain management, physical therapy to restore function and strength, and regular follow-up appointments to assess healing and stability of the knee. Patients are often advised to avoid weight-bearing activities for a specified period to allow for proper recovery. The healthcare team will provide specific instructions regarding rehabilitation and any necessary restrictions to ensure optimal recovery outcomes.

Short Descr TREAT KNEE DISLOCATION
Medium Descr OPEN TX KNEE DISLOCATION W/O LIGAMENTOUS REPAIR
Long Descr Open treatment of knee dislocation, includes internal fixation, when performed; without primary ligamentous repair or augmentation/reconstruction
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 Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P3D - Major procedure, orthopedic - other
MUE 1
CCS Clinical Classification 147 - Treatment, fracture or dislocation of lower extremity (other than hip or femur)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
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).
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.)
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)
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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2008-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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