2025 CPT code 27516

Closed treatment of distal femoral epiphyseal separation; without manipulation.

This code is specific to closed treatment without manipulation. If manipulation is performed, or if the treatment is open (surgical), a different code should be used. Follow CPT guidelines for appropriate code selection.

Modifiers may be applicable to this code to indicate specific circumstances, such as bilateral procedures (modifier 50) or reduced services (modifier 52). Modifier 54 (Surgical Care Only) may be used if the physician applying the cast is not managing the subsequent care.

Medical necessity for this procedure is established by imaging evidence of a distal femoral epiphyseal separation. The documentation should demonstrate the need for closed treatment without manipulation to stabilize the injury and promote proper healing.

The physician is responsible for evaluating the fracture through X-rays, applying the stabilizing cast, monitoring the healing process, and removing the cast when appropriate.

IMPORTANT For closed treatment with manipulation, use 27517. For open treatment with internal fixation, use 27519.

In simple words: This procedure treats a separation at the growth plate of the thigh bone near the knee in children, without surgery. A cast is applied to stabilize the area and allow it to heal.

This code represents the closed treatment of a distal femoral epiphyseal separation without manipulation. This procedure is typically performed on young children and involves stabilizing the separation between the epiphysis (the end part of the femur) and the rest of the bone, often using a cast.It does not include manipulation (realignment) of the separated bone fragments.

Example 1: A 10-year-old child falls from a tree and experiences pain and limited mobility in their knee. X-rays reveal a distal femoral epiphyseal separation. The physician performs a closed reduction without manipulation and applies a hip spica cast to stabilize the injury., A young athlete sustains a distal femoral epiphyseal separation during a sporting event.Due to minimal displacement, manipulation is not necessary.The physician applies a cast for stabilization and schedules follow-up visits to monitor healing., An adolescent presents with knee pain after a minor fall. Imaging confirms a minimally displaced distal femoral epiphyseal separation.Closed treatment without manipulation, using a cast for immobilization, is chosen to promote healing without surgery.

Documentation should include the diagnosis, mechanism of injury, X-ray findings detailing the separation, type of cast applied, and any associated injuries. Follow-up notes should document the healing progression and any complications.

** Additional supplies, such as casting materials, may be reported separately using appropriate HCPCS codes.Evaluation and management services may be reported separately with appropriate modifiers if significant and separately identifiable services are provided on the same day.

  • Revenue Code: P6B
  • Specialties:Orthopedic Surgery, Pediatric Orthopedics, Sports Medicine
  • Place of Service:Office, Hospital Outpatient Department, Emergency Room - Hospital, Ambulatory Surgical Center
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