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The procedure described by CPT® Code 27607 involves making an incision in the leg or ankle to address conditions such as osteomyelitis or a bone abscess. Osteomyelitis refers to an infection of the bone, while a bone abscess is a localized collection of pus within the bone. During this surgical intervention, the bone cortex of the tibia, fibula, talus, or calcaneus is accessed to treat the underlying infection. The process begins with an incision through the skin and soft tissue that overlays the infected bone area. This incision allows the surgeon to elevate the periosteum, which is the connective tissue that covers the bone, exposing the infected region. A small section, or button, of the cortical bone is then removed to access the bone marrow, which is crucial for relieving pressure caused by inflammation. This step is vital as it helps restore blood flow to the affected area, which is often compromised due to the infection. If pus is present, the surgeon may need to enlarge the initial incision to effectively drain the abscess, ensuring that the infection is adequately addressed. In cases where the epiphysis, the end part of a long bone, is involved, a portion of the epiphyseal cortex may also be excised to facilitate thorough drainage and treatment of the infection.
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The procedure described by CPT® Code 27607 is indicated for specific conditions affecting the leg or ankle, particularly when there is a need to address infections within the bone. The following are the primary indications for performing this procedure:
The procedure for CPT® Code 27607 involves several critical steps to effectively treat the infected bone. Each step is essential for ensuring that the infection is adequately addressed and that the patient can recover properly.
After the procedure, patients can expect specific post-operative care to promote healing and prevent complications. The surgical site will need to be monitored for signs of infection, and appropriate wound care instructions will be provided. Pain management may be necessary, and patients may be advised to limit weight-bearing activities on the affected leg or ankle during the initial recovery phase. Follow-up appointments will be essential to assess healing and ensure that the infection has been adequately resolved. Additionally, any prescribed antibiotics should be taken as directed to support the healing process and prevent recurrence of the infection.
| Short Descr | TREAT LOWER LEG BONE LESION | Medium Descr | INCISION LEG/ANKLE | Long Descr | Incision (eg, osteomyelitis or bone abscess), leg or ankle | 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) | 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 | 161 - Other OR therapeutic procedures on bone |
| XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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). | LT | Left side (used to identify procedures performed on the left side of the body) | 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. | 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. | 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). | 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). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code 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 | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | RT | Right side (used to identify procedures performed on the right side of the body) | TA | Left foot, great toe | 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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