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The CPT® Code 27566 refers to the open treatment of a patellar dislocation, which can occur due to trauma or a biomechanical imbalance in the knee joint, such as a condition known as patella alta, where the patella (kneecap) is positioned higher than normal. This procedure may involve a partial or total patellectomy, which is the surgical removal of part or all of the patella. The open reduction of an acute patellar dislocation is typically performed through an anterior approach, allowing the surgeon to directly access the patella and surrounding structures. During the procedure, the patella is carefully exposed and inspected, and any loose bodies that may hinder the reduction process are removed. Once the patella is manipulated back into its proper position, a second set of radiographs may be taken to confirm the successful reduction. In cases where the patella is severely damaged or requires excision, the muscles and tendons attached to it are divided, ensuring that the quadriceps tendon above and the patellar tendon below are preserved. After the patella is removed, the quadriceps and patellar tendons are sutured back together, and the soft tissues and skin are closed in layers. Post-surgery, the knee may be protected and immobilized using a compression wrap, splint, or cast to facilitate healing and recovery.
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The open treatment of patellar dislocation, as described by CPT® Code 27566, is indicated for the following conditions:
The procedure for the open treatment of patellar dislocation involves several critical steps:
After the open treatment of patellar dislocation, patients can expect a period of recovery that may involve immobilization of the knee to ensure proper healing. The use of a compression wrap, splint, or cast is common to protect the knee joint. Patients will typically be monitored for any signs of complications, and rehabilitation may be initiated to restore range of motion and strength. Follow-up appointments are essential to assess the healing process and to determine when it is safe to resume normal activities.
| Short Descr | TREAT KNEECAP DISLOCATION | Medium Descr | OPTX PATELLAR DISLC W/WO PRTL/TOT PATELLECTOMY | Long Descr | Open treatment of patellar dislocation, with or without partial or total patellectomy | 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 | 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 | 147 - Treatment, fracture or dislocation of lower extremity (other than hip or femur) |
| 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. | 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 | 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) |
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| Pre-1990 | Added | Code added. |
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