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The CPT® Code 27268 refers to the closed treatment of a femoral fracture at the proximal end, specifically the head, with manipulation. This procedure is indicated when a fracture at the femoral head is displaced, necessitating manual intervention to realign the bone fragments. Unlike the closed treatment without manipulation, as described in CPT® Code 27267, which is typically used for nondisplaced or minimally displaced fractures, the manipulation involved in this procedure is crucial for ensuring proper healing. Proximal end femoral head fractures are most commonly seen in younger patients, often resulting from traumatic incidents. The treatment begins with a thorough evaluation, including separately reportable radiographic studies, to assess the stability of the fracture. If the fracture is determined to be displaced, the physician will perform a closed reduction, which involves manually manipulating the bone fragments back into their correct anatomical position. This manipulation is essential for restoring the alignment necessary for optimal healing and recovery.
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The closed treatment of a proximal end femoral head fracture with manipulation (CPT® Code 27268) is indicated in the following scenarios:
The procedure for closed treatment of a proximal end femoral head fracture with manipulation involves several critical steps:
After the closed treatment with manipulation, the patient is expected to follow specific post-procedure care instructions. This includes adhering to weight-bearing restrictions to prevent further injury to the healing femoral head. Regular follow-up appointments may be necessary to monitor the healing process through additional radiographic evaluations. The patient should also be aware of signs of complications, such as increased pain, swelling, or changes in mobility, and report these to their healthcare provider promptly. Rehabilitation exercises may be introduced gradually, depending on the physician's assessment of the fracture's healing progress.
| Short Descr | CLTX THIGH FX W/MNPJ | Medium Descr | CLOSED TX FEMORAL FRACTURE PROX HEAD W/MANJ | Long Descr | Closed treatment of femoral fracture, proximal end, head; with manipulation | 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 | 146 - Treatment, fracture or dislocation of hip and 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). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 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) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2008-01-01 | Added | First appearance in code book in 2008. |
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