Ask Margie: Correct use of hip conversion code 27132: What the AMA says
Published Nov 7, 2008
Question: What is the intent of the hip conversion code 27132, especially in regard to "previous hip surgery?" Also, is there a time frame, and if so, does it include removal of old hardware? Could the code apply to a patient that as a child had hip dysplasia treated with a Pavlik harness, who now presents as an adult for total hip replacement (THR)? Could it apply to a patient that as a teenager dislocated his hip in a football game, had a reduction and now as an adult presents for a THR? Or could it apply to a patient that had a hip arthroscopy at a younger or older age, and now years later presents for THR? Or for a patient that had a previous hip pinning, plating, screws, etc., and now presents for a THR?
Answer: I recently sent the above series of questions to the AMA's CPT panel to get a clearer picture about the correct use of code 27132 (conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft).
The AMA had the following answers, in consultation with the American Academy of Orthopaedic Surgeons and the American Orthopaedic Association:
Intent of 27132 in regard to previous surgery: "Previous surgery results in scarring, deformity and an altered surgical field, making the procedure more difficult with potentially higher complication rates. It covers ANY previous surgery at any previous time where a skin incision was made."
Time frame and removal of old hardware: "There is no time frame associated with code 27132, conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft. Code 27132 includes removal of old hardware."
When a previous hip dysplasia was treated with a Pavlik harness: "A harness is not surgery, so use of code 27132 would not be appropriate in this instance. However, should the infant have undergone surgery, then code 27132 would be applicable."
For a teenager who dislocated hip in football game, then presents as an adult for THR: "If a closed reduction of the hip dislocation was performed, then code 27132 would not be appropriate in this instance. However, if an open hip reduction had been performed, then code 27132 would be applicable."
A patient that had hip arthroscopy and years later presents for THR: "In this specific circumstance, yes code 27132 would be applicable."
A patient that had a previous hip pinning, plating, screws, etc., and now presents for a THR: "In this specific circumstance, yes code 27132 would be applicable."
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