2025 CPT code 27299
(Active) Effective Date: N/A Surgery - Other Procedures on the Pelvis or Hip Joint Surgery Feed
This code is for unlisted procedures performed on the pelvis or hip joint.
Modifiers may be applicable depending on the specific circumstances. Modifier 22 (Increased Procedural Services) might be appropriate if the work required is substantially greater than usual. Other modifiers may be applicable based on specific payer guidelines.
Medical necessity must be clearly documented. The documentation should support why the procedure was performed and why it was necessary for the patient's condition. The medical record should demonstrate that the procedure was performed for a medically necessary reason and not for cosmetic or other non-covered reasons.
The physician or other qualified healthcare professional performs the unlisted procedure on the pelvis or hip joint. This professional is responsible for documenting the details of the procedure, including the reason for using an unlisted code, and for ensuring that the documentation supports the medical necessity of the procedure.
In simple words: This code represents a procedure on the pelvis or hip joint that doesn't have its own specific code.Your doctor will provide extra information about exactly what was done to help with billing.
This code is used for any procedure performed on the pelvis or hip joint that does not have a specific CPT code.It's crucial to provide detailed documentation with this code, including a description of the procedure performed, why a specific code wasn't applicable, and potentially comparable codes for reference to justify the billing amount.
Example 1: A patient presents with an unusual pelvic injury not covered by existing CPT codes. After surgical exploration, the surgeon performs a complex reconstruction of the pelvic ring using a novel technique. Due to the unique nature of the repair, code 27299 is used, accompanied by detailed documentation and supporting operative notes., A patient with a rare congenital hip abnormality undergoes a revision of a previous hip surgery. The revision involves a complex reconstruction of the acetabulum and femoral head, not adequately described by other codes. The surgeon uses 27299 and submits detailed documentation describing the procedure and its complexity., A patient undergoes a periacetabular osteotomy for hip dysplasia. Since there is no specific code for this complex procedure involving multiple cuts in the acetabulum, the surgeon uses 27299. The documentation includes a detailed description of each osteotomy and a reference to code 27146 (osteotomy of iliac, acetabular, or innominate bone) for comparison.
Detailed operative report describing the procedure performed. Justification for using the unlisted code 27299 and why a more specific code was not applicable. Supporting documentation such as imaging studies, pre- and post-operative diagnoses, and any other relevant clinical findings. When possible, similar or comparable CPT codes should be provided for reference to help justify the billing amount.
** This code requires careful documentation to ensure proper reimbursement.Contact the payer for specific billing guidelines and documentation requirements.
- Revenue Code: P3D - MAJOR PROCEDURE, ORTHOPEDIC - OTHER
- Payment Status: Active
- Specialties:Orthopedic Surgery, Pediatric Orthopedic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center